Individual
STEPHANIE ANITA BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
202 GJOA STREET, PETERSBURG, AK 99833
(907) 772-4963
Mailing address
PO BOX 226, PETERSBURG, AK 99833-0226
(907) 772-4963
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1332
AK
Other
Enumeration date
02/04/2014
Last updated
10/21/2014
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