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Individual

TERRY BATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1060 GAFFNEY RD #7440, FT WAINWRIGHT, AK 99703-7440
(907) 361-5603
Mailing address
1060 GAFFNEY RD #7440, FT WAINWRIGHT, AK 99703-7440
(907) 361-5603

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
361998-3501
UT

Other

Enumeration date
09/09/2011
Last updated
09/09/2011
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