Individual
TANYA IVANIVNA HALLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
2960 TONGASS AVENUE, FIRST FLOOR KETCHIKAN INDIAN COMMUNITY TRIBAL HEALTH CL, KETCHIKAN, AK 99901
(907) 228-4917
(907) 228-4920
Mailing address
2960 TONGASS AVENUE, FIRST FLOOR KETCHIKAN INDIAN COMMUNITY TRIBAL HEALTH CL, KETCHIKAN, AK 99901
(907) 228-4917
(907) 228-4920
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC#568
AK
101YA0400X
Addiction (Substance Use Disorder) Counselor
CERTIFICATE #3429
AK
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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