Individual
BENDICK J DIDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFW
Contact information
Practice address
4300 UNIVERSITY DR, JUNEAU, AK 99801-8649
(907) 364-4445
Mailing address
4300 UNIVERSITY DR, JUNEAU, AK 99801-8649
(907) 364-4445
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2180
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2180
STATE LICENSE
AK
Enumeration date
12/18/2009
Last updated
12/18/2009
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