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Individual

MRS. KAREN R BLACKBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
909 CUSHMAN ST STE 103, FAIRBANKS, AK 99701-4668
(907) 456-4620
(907) 457-6598
Mailing address
122 1ST AVE, SUITE 201, FAIRBANKS, AK 99701-4803
(907) 452-6434
(907) 457-6598

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
171400000X
Health & Wellness Coach
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
225600000X
Dance Therapist
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
372500000X
Chore Provider

Other

Enumeration date
07/20/2011
Last updated
07/10/2024
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