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BRENDA WILSON

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1972082592

Individual Registrant:
 BRENDA  WILSON 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
100 SLOCUM DRIVE  KING COVE, AK 99612-0009 US
Tel: 907-497-2311  Fax: 907-497-2310

Contact information for business:
PO BOX 9  KING COVE, AK 99612-0009 US
Tel: 907-497-2311  Fax: 907-497-2310

Registration Information:
NPI: 1972082592
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
AK2945

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AK - Page 1



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