MEDICARE: MISS SHARON DELOIS EVANS BS, QMHA

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
1	225C00000X	Rehabilitation Counselor

General Provider Information

NPI Number	:	1598073603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHARON DELOIS EVANS BS, QMHA

Provider Business Mailing Address
First Line	:	5423 SUNNYVILLE ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-7986
Country	:	US
Telephone Number	:	725-249-3798
Fax Number	:	877-526-3290

Provider Business Practice Location Address
First Line	:	736 HILL SHINE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2394
Country	:	US
Telephone Number	:	702-488-0004
Fax Number	:	877-526-3290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	04/12/2022

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