Individual
MICHELLE NIKOLE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SP.
Contact information
Practice address
602 CHASE AVE., CORDOVA, AK 99574
(907) 424-8300
(907) 424-8645
Mailing address
PO BOX 160, CORDOVA, AK 99574-0160
(907) 424-8300
(907) 424-8645
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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