Individual
KENDRA EVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 CALISTA DRIVE, BETHEL, AK 99559
(907) 543-6704
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
09/13/2021
Last updated
09/13/2021
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