Individual
JESSICA LYNN EVANCHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT, ATR-BC
Contact information
Practice address
29 W 36TH ST STE 5E, NEW YORK, NY 10018-7907
(817) 713-9088
Mailing address
29 W 36TH ST # 5E, NEW YORK, NY 10018-7907
(718) 260-6201
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002056
NY
Other
Enumeration date
11/13/2018
Last updated
11/24/2018
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