Individual
COLLEEN OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 SAN ERNESTO AVE, ANCHORAGE, AK 99508-2874
(907) 729-6351
Mailing address
4000 SAN ERNESTO AVE, ANCHORAGE, AK 99508-2874
(907) 729-6351
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
04/09/2020
Last updated
07/23/2021
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