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LILLIAN A OLANNA CHA-T
>> Community Health Worker >> Other Service ProvidersRegistrant NPI Number: 1295377976
Individual Registrant: LILLIAN A OLANNA CHA-T
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
85058 CLARENCE ROAD BREVIG MISSION, AK 99785-5058 US
Tel: 907-642-4311 Fax: 907-642-2216
Tel: 907-642-4311 Fax: 907-642-2216
Contact information for business:
PO BOX 85058 BREVIG MISSION, AK 99785-0058 US
Tel: 907-642-4311 Fax: 907-642-2216
Tel: 907-642-4311 Fax: 907-642-2216
Registration Information:
NPI: 1295377976
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172V00000X | Other Service Providers Community Health Worker | AK |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| CHA-T | CHA-T | AK | 01 |
