Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 115521 | AK |
NPI | 1003109265 |
---|---|
Provider Name | Carrie Cravens |
First Address | Anchorage, AK 99501-2815 |
Second Address | Anchorage, AK 99508-3782 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2011 |
Last Update Date | 30/04/2017 |