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TINA RENEE JAMES-GAMBLE DHA II

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1902247059

Individual Registrant:
 TINA RENEE JAMES-GAMBLE DHA II
Gender: F
Not Sole Proprietor

Location and contact information for practice:
725 RELAY ROAD  ANGOON, AK 99820 US
Tel: 907-788-4655  Fax: 907-788-3180

Contact information for business:
725 RELAY ROAD PO BOX 287 ANGOON, AK 99820 US
Tel: 907-788-4655  Fax: 907-788-3180

Registration Information:
NPI: 1902247059
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD NUMBER07-044-PDHA IIAK01




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