Individual
TIANA R TETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1825 MARIKA RD, FAIRBANKS, AK 99709-5521
(907) 474-0890
Mailing address
1436 BIRCHWILLOW DR UNIT 2, FAIRBANKS, AK 99712-3064
(907) 799-7174
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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