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Individual

SUSAN E STANTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLC

Contact information

Practice address
480 UNIVERSITY AVE, FAIRBANKS, AK 99709-3639
(907) 347-2160
Mailing address
480 UNIVERSITY AVE, FAIRBANKS, AK 99709-3639
(907) 347-2160

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
830
AK
101YP2500X
Professional Counselor
Primary
830
AK
101YS0200X
School Counselor
4051697
AK

Other

Enumeration date
03/04/2014
Last updated
03/17/2014
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