Individual
MARIANTHI BASDARAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 W 31ST AVE, ANCHORAGE, AK 99503-3624
(907) 302-9164
Mailing address
PO BOX 241224, ANCHORAGE, AK 99524-1224
(907) 302-9164
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-146023
AK
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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