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Individual

JANICE MESDAG CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, CDCI

Contact information

Practice address
2913 SIMPSON AVE, JUNEAU, AK 99801-2046
(907) 635-5551
Mailing address
2913 SIMPSON AVE, JUNEAU, AK 99801-2046
(907) 635-5551

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
602
AK

Other

Enumeration date
01/13/2015
Last updated
01/13/2015
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