Provider Demographics
NPI:1801104450
Name:MASCOE, EVET C
Entity type:Individual
Prefix:MRS
First Name:EVET
Middle Name:C
Last Name:MASCOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8831 ELLIOTTS CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5028
Mailing Address - Country:US
Mailing Address - Phone:407-352-6020
Mailing Address - Fax:
Practice Address - Street 1:8831 ELLIOTTS CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-5028
Practice Address - Country:US
Practice Address - Phone:407-352-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker