Provider Demographics
NPI:1770844011
Name:QUICK-EVANS, INEZ (LSW)
Entity Type:Individual
Prefix:MS
First Name:INEZ
Middle Name:
Last Name:QUICK-EVANS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 CECIL B MOORE AVE
Mailing Address - Street 2:MEN&WOMEN FOR HUMAN EXCELLENCE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-2826
Mailing Address - Country:US
Mailing Address - Phone:215-769-7045
Mailing Address - Fax:215-769-7046
Practice Address - Street 1:2603 CECIL B MOORE AVE
Practice Address - Street 2:MEN&WOMEN FOR HUMAN EXCELLENCE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-2826
Practice Address - Country:US
Practice Address - Phone:215-769-7045
Practice Address - Fax:215-769-7046
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010315L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health