Individual
SYDNEY GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7010 E BOGARD RD, WASILLA, AK 99654-4711
(907) 373-4732
Mailing address
2521 E MOUNTAIN VILLAGE DR STE B, WASILLA, AK 99654-7377
(907) 521-8144
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/03/2020
Last updated
10/05/2023
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