Provider Demographics
NPI:1073385167
Name:CARRASCAL, EVELYN ELIZABETH
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:ELIZABETH
Last Name:CARRASCAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:ELIZABETH
Other - Last Name:CARRASCAL-FISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6024 W COLORADO LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6484
Mailing Address - Country:US
Mailing Address - Phone:703-309-7827
Mailing Address - Fax:
Practice Address - Street 1:6024 W COLORADO LN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6484
Practice Address - Country:US
Practice Address - Phone:703-309-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist