Individual
TANISHA EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1345 BARNUM AVE, STRATFORD, CT 06614-5422
(475) 219-8069
Mailing address
1345 BARNUM AVE, STRATFORD, CT 06614-5422
(475) 219-8069
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7389
CT
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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