Individual
MARIAH HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
3065 COLLEGE RD, FAIRBANKS, AK 99709-3702
(907) 374-1686
Mailing address
216 SLATER DR, FAIRBANKS, AK 99701-3430
(907) 251-6535
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
183830
AK
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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