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NPI Code Detail

MEDICARE: ALIJAH EVANS

MEDICARE:   ALIJAH  EVANS
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
2101YA0400XAddiction (Substance Use Disorder) Counselor
3103K00000XBehavior Analyst
4173000000XLegal Medicine
5251J00000XNursing Care Agency
6332B00000XDurable Medical Equipment & Medical Supplies
7333600000XPharmacy
8103T00000XPsychologist

General Provider Information

NPI Number : 1053160002
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIJAH EVANS
Provider Business Mailing Address
First Line : 2712 E TOWER DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-6428
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5011 HAWAIIAN TER
Second Line :
City : CINCINNATI
State : OH
Zip : 45223-1152
Country : US
Telephone Number : 513-734-5423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2024
Last Update Date : 05/14/2024

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Directions to “ ALIJAH EVANS ” Practice Location

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