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THEODORE COOPER SUTTON FSWC I/COUNSELOR

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

Registrant NPI Number: 1215119201

Individual Registrant:
 THEODORE COOPER SUTTON FSWC I/COUNSELOR
Gender: M
Not Sole Proprietor

Location and contact information for practice:
MAIN STREET BRISTOL BAY AREA HEALTH CORPORATION TOGIAK BEHAVIORAL HEALTH PROGRAM, FAMILY RESOURCE BLD. TOGIAK, AK 99678-0409 US
Tel: 907-493-5637  Fax: 907-493-5184

Contact information for business:
BRISTOL BAY AREA HEALTH CORPORATION TOGIAK BEHAVIORAL HEALTH PROGRAM, P.O. BOX 409 TOGIAK, AK 99678-0409 US
Tel: 907-493-5637  Fax: 907-493-5184

Registration Information:
NPI: 1215119201
Entity Type: Individual

Specialty information:

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

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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