Provider Demographics
NPI:1720480726
Name:EVANS, ARNITA (LLBSW)
Entity Type:Individual
Prefix:
First Name:ARNITA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-1620
Mailing Address - Country:US
Mailing Address - Phone:810-323-6081
Mailing Address - Fax:810-232-6510
Practice Address - Street 1:929 STEVENS ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502
Practice Address - Country:US
Practice Address - Phone:810-232-6081
Practice Address - Fax:810-232-6510
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802088251171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator