Organization
FBX FAIRBANKS BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN TANORI MA, BCBA (OWNER)
(907) 378-3434
Entity
Organization
Contact information
Practice address
3245 CRAFT AVE, FAIRBANKS, AK 99709-5772
(907) 378-3434
(907) 374-0820
Mailing address
PO BOX 80448, FAIRBANKS, AK 99708-0448
(907) 378-3434
(907) 374-0820
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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