Individual
THEODORE LOLE TAUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
741 N BUNN ST APT 4, ANCHORAGE, AK 99508-1696
(907) 333-2468
Mailing address
500 E TUDOR RD STE 200, ANCHORAGE, AK 99503-7377
(907) 333-2468
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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