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Individual

MS. PRISCILLA WAUNEKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EMT 1

Contact information

Practice address
1360 CALISTA DR., BH SOBERING CENTER, BETHEL, AK 99559-0528
(907) 545-6830
Mailing address
PO BOX 528, ATTN: BH SOBERING CENTER, BETHEL, AK 99559-0528
(907) 543-6830

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
146M00000X
Intermediate Emergency Medical Technician
13289003
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1020986
AK
Enumeration date
08/12/2011
Last updated
06/11/2014
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