Individual ProviderEvelyn SquillariCounselorBehavioral Health & Social Service ProvidersPractice Address6171 W Charleston Blvd Bldg 12-W, Las Vegas, NV 89146-1126(702) 486-7717PECOS EnrollmentBased on the most recent information from CMS, provider Evelyn Squillari does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1245746585Provider TypeIndividualFull NameSquillari, EvelynGenderFemaleSole ProprietorNoEnumeration Date12/22/2017Last Updated12/22/2017Contact InformationPractice LocationPractice Address6171 W Charleston Blvd Bldg 12-W, Las Vegas, NV 89146-1126Phone(702) 486-7717FaxUnlisted FaxMailing LocationMailing Address6171 W Charleston Blvd Bldg 12w, Las Vegas, NV 89146-1126Phone(702) 486-7717FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer