Healthcare Provider Details

I. General information

NPI: 1841412673
Provider Name (Legal Business Name): EVAN SMITH CAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 06/15/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 SWEET HOME RD
AMHERST NY
14228-2795
US

IV. Provider business mailing address

1412 SWEET HOME RD STE 3-5
AMHERST NY
14228-2795
US

V. Phone/Fax

Practice location:
  • Phone: 716-589-1411
  • Fax: 716-881-2425
Mailing address:
  • Phone: 716-589-1411
  • Fax: 716-559-1572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number001118-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number7901198
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: