JACOB RUSSELL EVANS

NAMPA, ID
NPI1902780331
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  5120)
Enumeration Date2025-07-31
Last Update Date2025-07-31
Business Address
JACOB RUSSELL EVANS
58 N GRANITE FALLS DR
NAMPA, ID 83651-5198
Phone number: 304-839-5448
Mailing Address
JACOB RUSSELL EVANS
58 N GRANITE FALLS DR
NAMPA, ID 83651-5198
Phone number: 304-839-5448
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