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DESIREE GOLD

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1366685455

Individual Registrant:
 DESIREE  GOLD 
Gender: F
Sole Proprietor

Location and contact information for practice:
18606 OLD GLENN HWY  CHUGIAK, AK 99567-1750 US
Tel: 907-688-0282  Fax: --

Contact information for business:
PO BOX 671750  CHUGIAK, AK 99567-1750 US
Tel: 907-688-0282  Fax: --

Registration Information:
NPI: 1366685455
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CMG121AK05
HC1621AK05




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