Individual
ALYSSA WAINANI EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-1000
Mailing address
7911 ELMONT RD, SULLIVAN, MO 63080-3601
(314) 708-9375
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4771566
ID
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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