Individual
FAITH BRAINERD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18606 OLD GLEN HIGHWAY, CHUGIAK, AK 99567-1750
(907) 688-0282
(907) 688-2013
Mailing address
PO BOX 671750, CHUGIAK, AK 99567-1750
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/31/2007
Last updated
02/28/2008
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