Evolo Pllc

NPI #1043075302 in Hailey, Idaho

Provider Information

NPI Number: 1043075302
Entity Type: Organization
Organization Name: Evolo Pllc
Primary Specialty: Counselor - Mental Health
Enumeration Date: Feb 15, 2024
Last Updated: Feb 15, 2024

Practice Location

Address: 416 S MAIN ST STE 102
City: Hailey
State: Idaho
ZIP Code: 83333-8422
Phone: (208) 727-7360

Authorized Official

Name: MRS. KATHRYN E CANNELL, LPC
Title: OWNER/FOUNDER
Phone: (208) 727-7360

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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