Individual
LESLIE SKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 E SWANSON AVE, SUITE 1, WASILLA, AK 99654-7025
(907) 357-7962
Mailing address
131 E SWANSON AVE, SUITE 1, WASILLA, AK 99654-7025
(907) 357-7962
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM6101
STATE
AK
Enumeration date
08/11/2014
Last updated
08/11/2014
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