Individual
SAMANTHA HUSTRULID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 CORDOVA ST, ANCHORAGE, AK 99503-2745
(907) 279-9640
Mailing address
2600 CORDOVA ST STE 101, ANCHORAGE, AK 99503-2745
(907) 279-9640
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/13/2019
Last updated
07/22/2021
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