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NPI Code Detail

MEDICARE: MARGARET B EVANS LISW

MEDICARE: MARGARET B EVANS LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerI-0004774OH

General Provider Information

NPI Number : 1215042130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET B EVANS LISW
Provider Business Mailing Address
First Line : 1510 STARK AVE SW
Second Line :
City : CANTON
State : OH
Zip : 44706-2860
Country : US
Telephone Number : 330-455-5021
Fax Number :
Provider Business Practice Location Address
First Line : 919 2ND ST NE
Second Line :
City : CANTON
State : OH
Zip : 44704-1132
Country : US
Telephone Number : 330-454-7917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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Directions to “ MARGARET B EVANS LISW” Practice Location

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