Individual
MICHAEL H ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, BETHEL, AK 99559-0528
(907) 543-6100
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LASAC-13106
AZ
101YM0800X
Mental Health Counselor
LH60113447
WA
101YP2500X
Professional Counselor
624-2-1-09
ND
101YP2500X
Professional Counselor
Primary
628
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4442
—
AK
Enumeration date
08/06/2009
Last updated
04/09/2010
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