Provider Information for 1467406488
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EVELYN IMES COSMAI LMHC
Sex: Female
NPI: 1467406488
Last Updated: 2009-10-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1467406488 | ||||||||
| Enumeration Date | 2006-05-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1629 BEDFORDSHIRE BEDFORD, TX 76021-4640 United States Phone: 407-301-2594 | Fax: | ||||||||
| Primary Practice Address | 1629 BEDFORDSHIRE BEDFORD, TX 76021-4640 United States Phone: 407-301-2594 | Fax: | ||||||||
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