Individual
ALEXANDER NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 BIDWILL AVE STE 103, FAIRBANKS, AK 99701-7587
(907) 452-1648
Mailing address
PO BOX 73004, FAIRBANKS, AK 99707-3004
(907) 374-1097
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1687081
—
AK
Enumeration date
05/03/2021
Last updated
03/23/2022
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