Organization
AHTNA T' AENE NENE'
Active
Other names
Copper River Native Association
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI R WIEDLUND (PATIENT FINANCIAL SERVICES MANAGER)
(907) 206-6812
Entity
Organization
Contact information
Practice address
MP 111.5 RICHARDSON HWY, COPPER CENTER, AK 99573-0508
(907) 822-5241
(907) 822-8801
Mailing address
PO BOX 383, GLENNALLEN, AK 99588-0383
(907) 822-5241
(907) 822-8801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
36087
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4434
—
AK
05
—
MH0641
—
AK
Enumeration date
02/08/2007
Last updated
02/28/2024
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