Individual
LORA JAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 FRONT ST STE 202, JUNEAU, AK 99801-1244
(218) 576-2659
Mailing address
225 FRONT ST STE 202, JUNEAU, AK 99801-1244
(218) 576-2659
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
03/30/2022
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