Most Relevant Information
Provider Data
| NPI Number: | 1003010711 |
| Provider Name: | LISA MARIE EVANICH MA, LPC, CACIII |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 6457 |
Most Important Dates
| Enumeration Date: | 06/14/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
360 28 RD
GRAND JUNCTION
CO
815014759
Practice Location Phone/Fax
| Phone: | 9702603321 |
| Fax: |
Provider Mailing Location
360 28 RD
GRAND JUNCTION
CO
815014759
Provider Mailing Phone/Fax
| Phone: | 9702603321 |
| Fax: |