Individual
GWENDOLYNN STACY CHICKALUSION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COUNSELOR TECHNICIAN
Contact information
Practice address
1230 OCEAN DR STE 1, HOMER, AK 99603-7911
(907) 235-8319
(907) 235-8099
Mailing address
PO BOX 2352, HOMER, AK 99603-2352
(907) 235-8001
(907) 235-8099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5068
AK
Other
Enumeration date
10/13/2023
Last updated
10/13/2023
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