Individual
DESERAE STELLWAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 COPPER MOUNTAIN STREET, TATITLEK, AK 99677
(907) 325-2235
Mailing address
PO BOX 172, TATITLEK, AK 99677-0172
(907) 325-2235
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AK
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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