Individual
SUSANA DORIAN BENNETT-MELENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9800
Mailing address
PO BOX 149, OUZINKIE, AK 99644-0149
(907) 486-1390
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
19-161-BHA1
AK
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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