Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003476946 |
---|---|
Provider Name | Hammie Davidson |
First Address | Anchorage, AK 99503-3953 |
Second Address | Anchorage, AK 99503-3953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2019 |
Last Update Date | 24/01/2020 |