Individual
KENOSHA BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 E 74TH AVENUE, ANCHORAGE, AK 99507
(907) 205-8473
Mailing address
1550 E 74TH AVENUE, ANCHORAGE, AK 99507
(907) 205-8473
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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