Individual
BETHANY EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
340 HIGHWAY 138, CRESTLINE, CA 92325
(909) 336-3330
Mailing address
PO BOX 6300, CRESTLINE, CA 92325-6300
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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