Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CDC I | AK |
N | 101YM0800X | Mental Health Counselor | MH 2389 | FL |
NPI | 1003022856 |
---|---|
Provider Name | Ms. Lynn Roberta Harrison |
First Address | Fairbanks, AK 99707-4083 |
Second Address | Fairbanks, AK 99701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 10/07/2015 |