Individual
THOMAS JERAD HAUGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDCC III
Contact information
Practice address
3050 FIFTH AVE STE 100, KETCHIKAN, AK 99901-5773
(907) 463-0629
Mailing address
3050 FIFTH AVE STE 100, KETCHIKAN, AK 99901-5773
(907) 463-0629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9184
CA
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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