Provider Demographics
NPI:1659717346
Name:MANUEL, EVELYN CHRISTINA (INDEPENDENT PROVIDER)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:CHRISTINA
Last Name:MANUEL
Suffix:
Gender:F
Credentials:INDEPENDENT PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3484 WILKES CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-1260
Mailing Address - Country:US
Mailing Address - Phone:513-568-8910
Mailing Address - Fax:
Practice Address - Street 1:3484 WILKES CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1260
Practice Address - Country:US
Practice Address - Phone:513-568-8910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator