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NPI Code Detail

MEDICARE: MITCHEL EVANS B.S. HUMAN SERVICES

MEDICARE:   MITCHEL  EVANS  B.S. HUMAN SERVICES
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1740578160
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHEL EVANS B.S. HUMAN SERVICES
Provider Business Mailing Address
First Line : 4650 N RAINBOW BLVD APT 1035
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5759
Country : US
Telephone Number : 702-882-9359
Fax Number :
Provider Business Practice Location Address
First Line : 4650 N RAINBOW BLVD APT 1035
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5759
Country : US
Telephone Number : 702-882-9359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2011
Last Update Date : 07/19/2011

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Directions to “ MITCHEL EVANS B.S. HUMAN SERVICES” Practice Location

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