Most Relevant Information
Provider Data
| NPI Number: | 1003669391 |
| Provider Name: | TANISHA ELZEATHA EVANS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 101YA0400X |
Most Important Dates
| Enumeration Date: | 04/08/2024 |
| Last Updated: | 04/08/2024 |
Provider Practice Location
2581 ATLANTIC AVE
BROOKLYN
NY
112072412
Practice Location Phone/Fax
| Phone: | 7184956700 |
| Fax: |
Provider Mailing Location
47 FURMAN AVE APT 6
BROOKLYN
NY
112071735
Provider Mailing Phone/Fax
| Phone: | 6465658473 |
| Fax: |