Individual
MARY SUSAN TIEDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 NORTH NORDIC DRIVE, PETERSBURG, AK 99833
(907) 772-3332
(888) 858-8850
Mailing address
PO BOX 1309, PETERSBURG, AK 99833-1309
(907) 772-3332
(888) 858-8850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
293
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH1413
—
AK
Enumeration date
02/18/2010
Last updated
02/18/2010
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