Individual
MARIAM CORPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 S SEWARD MERIDIAN PKWY STE ABC, WASILLA, AK 99654-8312
(907) 334-6053
Mailing address
1550 E 74TH AVENUE, ANCHORAGE, AK 99507
(907) 205-8473
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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