| Evolucion Of Wellness Llc | |
|
133 Maple St Ste 201 Springfield MA 01105-1896 | |
| (413) 225-1197 | |
| (413) 238-6461 |
| Full Name | Evolucion Of Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 133 Maple St Ste 201, Springfield, Massachusetts |
| Authorized Official Name and Position | Ileana I Hernandez (PROVIDER) |
| Authorized Official Contact | 4134261321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolucion Of Wellness Llc 1129 Riverdale St # 1019 West Springfield MA 01089-4615 Ph: (413) 426-1321 | Evolucion Of Wellness Llc 133 Maple St Ste 201 Springfield MA 01105-1896 Ph: (413) 225-1197 |
| NPI Number | 1568197416 |
|---|---|
| Provider Enumeration Date | 07/22/2022 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568197416 | NPI | - | NPPES |
| 1891049664 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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