Individual
JUDY PLETNIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
916 STELLAR WAY, KODIAK, AK 99615-6490
(907) 942-1280
Mailing address
PO BOX 147, KODIAK, AK 99615-0147
(907) 942-1280
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004443
—
AK
Enumeration date
02/06/2019
Last updated
02/06/2019
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