Individual
ERIC EDWARD VILLASENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 E TUDOR RD STE 9A, ANCHORAGE, AK 99507-1036
(907) 332-0065
(907) 290-3261
Mailing address
1515 E TUDOR RD STE 9A, ANCHORAGE, AK 99507-1036
(907) 332-0065
(907) 290-3261
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
DSDSCERT
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7502796
AKDL
AK
Enumeration date
06/02/2020
Last updated
11/27/2023
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