Individual
WENDY ANN BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
526 GAFFNEY RD STE 100, FAIRBANKS, AK 99701-4914
(907) 687-5332
Mailing address
4191 6TH ST APT 4, FORT WAINWRIGHT, AK 99703-1249
(912) 401-5020
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
190873
AK
Other
Enumeration date
12/03/2018
Last updated
12/28/2022
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