Provider Demographics
NPI:1316620412
Name:EVESLEY, HELEN MARIA
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:MARIA
Last Name:EVESLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3438 SUMMERCOURT DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1363
Mailing Address - Country:US
Mailing Address - Phone:773-680-5510
Mailing Address - Fax:
Practice Address - Street 1:3438 SUMMERCOURT DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1363
Practice Address - Country:US
Practice Address - Phone:773-680-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician