Individual
MISS AMANDA RACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251
(907) 459-3883
Mailing address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251
(907) 459-3883
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM2668
—
AK
05
—
CMG438
—
AK
Enumeration date
05/16/2007
Last updated
07/15/2008
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