Individual
FAWN CHYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 987-5157
(907) 486-9898
Mailing address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 987-5157
(907) 486-9898
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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