Individual
CAROLYN MARY VILLAGECENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 FORTY MILE AVENUE, FAIRBANKS, AK 99701-3110
(907) 456-6445
(907) 456-6402
Mailing address
209 FORTY MILE AVENUE, FAIRBANKS, AK 99701-3110
(907) 456-6445
(907) 456-6402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
05/29/2024
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