Provider Demographics
NPI:1962149302
Name:ARROWOOD, EVAN PATRICK (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:PATRICK
Last Name:ARROWOOD
Suffix:
Gender:M
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-5860
Mailing Address - Country:US
Mailing Address - Phone:989-839-2290
Mailing Address - Fax:
Practice Address - Street 1:504 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1723
Practice Address - Country:US
Practice Address - Phone:989-285-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician