Individual
SALLY ANN CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-S, MAC, SEP
Contact information
Practice address
1929 AIRPORT WAY STE B, FAIRBANKS, AK 99701-4009
(907) 891-7877
(907) 917-4887
Mailing address
1929 AIRPORT WAY STE B, FAIRBANKS, AK 99701-4009
(907) 891-7877
(907) 917-4887
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
507483
AK
101YP2500X
Professional Counselor
Primary
562
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13892355
CAQH
AK
Enumeration date
02/02/2009
Last updated
09/13/2024
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