Healthcare Provider Details

I. General information

NPI: 1811817224
Provider Name (Legal Business Name): EVELIA MOTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 E PRESTON ST
MT PLEASANT MI
48858-8990
US

IV. Provider business mailing address

2012 E PRESTON ST
MT PLEASANT MI
48858-8990
US

V. Phone/Fax

Practice location:
  • Phone: 989-824-1407
  • Fax: 989-773-4319
Mailing address:
  • Phone: 989-824-1407
  • Fax: 989-773-4319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: