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Individual

KARA GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3524 INDUSTRIAL AVE, FAIRBANKS, AK 99701-7376
(907) 290-6395
Mailing address
4328 CEDAR ST UNIT 8, FORT WAINWRIGHT, AK 99703-1360

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-91896
AK

Other

Enumeration date
07/08/2019
Last updated
07/08/2019
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