Individual
DANIELLE WOLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4272 TIMBERLAND LOOP, WASILLA, AK 99654
(907) 521-0890
Mailing address
4272 TIMBERLAND LOOP, WASILLA, AK 99654
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
8954
AK
247200000X
Other Technician
RBT-15-05218
MS
Other
Enumeration date
10/08/2015
Last updated
03/17/2018
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