Individual
SUSAN B GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
3449 REZANOF DRIVE EAST, KODIAK, AK 99615
(907) 486-9800
(907) 486-9896
Mailing address
3449 REZANOF DRIVE EAST, KODIAK, AK 99615
(907) 486-9800
(907) 486-9896
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2427
TX
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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