Provider Demographics
NPI:1568164333
Name:EVANS SPEECH AND LANGUAGE THERAPY
Entity Type:Organization
Organization Name:EVANS SPEECH AND LANGUAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEY-EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:508-367-3731
Mailing Address - Street 1:34 BUXUS SHORES CIR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2678
Mailing Address - Country:US
Mailing Address - Phone:508-367-3731
Mailing Address - Fax:
Practice Address - Street 1:34 BUXUS SHORES CIR
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2678
Practice Address - Country:US
Practice Address - Phone:508-367-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty