Individual
TANDALARIETTE K COLLEADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 455-1407
(907) 455-1460
Mailing address
1308 GOLD RUSH DR, FAIRBANKS, AK 99709-3153
(907) 799-1072
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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