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Individual

KRISTIE EVANGELOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
201 CEDAR ST, ONEIDA, NY 13421-2111
(607) 753-0234
(607) 299-4349
Mailing address
10 N MAIN ST, CORTLAND, NY 13045-2130

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
006578
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1336163963
NY
Enumeration date
06/09/2016
Last updated
06/09/2016
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