Individual
MAPLE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED ECSE
Contact information
Practice address
56 SWEETBERRY CT, ALPHARETTA, GA 30005-6447
(612) 840-1701
Mailing address
56 SWEETBERRY CT, ALPHARETTA, GA 30005-6447
(612) 840-1701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1011626
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011626
SPECIAL EDUCATION TEACHING LICENSE
GA
Enumeration date
06/06/2016
Last updated
06/06/2016
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