Provider Demographics
NPI:1447085451
Name:EVEILLARD, TAINA MELISSA
Entity type:Individual
Prefix:
First Name:TAINA
Middle Name:MELISSA
Last Name:EVEILLARD
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 1:15999 SW 8TH AVE APT A202
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-2184
Mailing Address - Country:US
Mailing Address - Phone:786-376-2801
Mailing Address - Fax:
Practice Address - Street 1:15999 SW 8TH AVE APT A202
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-2184
Practice Address - Country:US
Practice Address - Phone:786-376-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical