Individual
AMBER DORIS MAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDC I
Contact information
Practice address
209 FORTY MILE AVENUE, FAIRBANKS, AK 99701-3110
(907) 452-8251
Mailing address
209 FORTY MILE AVENUE, FAIRBANKS, AK 99701-3110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
246135
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG 438
—
AK
Enumeration date
10/04/2012
Last updated
11/17/2022
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