NPI 1740849819 · live from the CMS NPI Registry
Alyssa Marie Agnes
Counselor, Addiction (Substance Use Disorder) in Fairbanks, AK. National Provider Identifier 1740849819, active.
NPI record
| NPI | 1740849819 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Addiction (Substance Use Disorder) 101YA0400X |
| Practice location | 1521 S Cushman St, Fairbanks, AK 99701 |
| Practice phone | 907-452-8251 |
| Enumerated | June 11, 2019 |
| Last updated | June 12, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) primary | 101YA0400X | — (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.