Individual
SUSAN REED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 GREY WOLF DR, WASILLA, AK 99654-1837
(907) 357-9599
Mailing address
4020 GREY WOLF DR, WASILLA, AK 99654-1837
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
435062
AK
251B00000X
Case Management Agency
435062
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG802
—
AK
Enumeration date
05/21/2007
Last updated
03/10/2008
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