Individual
JOHN GERALD MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 1ST AVE, FAIRBANKS, AK 99701-4871
(907) 452-8251
Mailing address
122 1ST AVE, FAIRBANKS, AK 99701-4871
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021051
—
AK
Enumeration date
09/26/2019
Last updated
09/26/2019
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