Individual
DONALD KENTON HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW SOCIAL WORKER
Contact information
Practice address
5325 ASPEN STREET, WASILLA, AK 99654-5325
(907) 373-4692
Mailing address
PO BOX 872023, WASILLA, AK 99687-2023
(907) 373-4692
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
290674
AK
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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