MR. Manuel Nazareno Evangelista, LCSW

NPI #1467787515 in Salt Lake, Utah

Provider Information

NPI Number: 1467787515
Entity Type: Individual
Name: MR. Manuel Nazareno Evangelista, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LCSW
Enumeration Date: Oct 7, 2009
Last Updated: Oct 7, 2009

Practice Location

Address: 860 EAST 4500 SOUTH #302
City: Salt Lake
State: Utah
ZIP Code: 84107
Phone: (801) 268-0333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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