Individual
MS. SUSAN LOUISE HENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
3245 HOSPITAL DRIVE, SEARHC, JUNEAU, AK 99801
(907) 364-4476
Mailing address
3005 BLUEBERRY HILLS RD S, JUNEAU, AK 99801-1989
(907) 364-3293
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3
STATE OF ALASKA LICENSED DIETITIAN
AK
Enumeration date
09/06/2011
Last updated
09/06/2011
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