Individual
CESSNIE J SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA, CMA
Contact information
Practice address
542 4TH AVE STE B101, FAIRBANKS, AK 99701
(907) 374-1097
(907) 374-1062
Mailing address
PO BOX 73004, FAIRBANKS, AK 99707-3004
(907) 374-1097
(907) 374-1062
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134588528
—
AK
05
—
475291237
—
AK
Enumeration date
08/30/2018
Last updated
03/06/2020
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