Individual
ELIZA EPHAMKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDC1
Contact information
Practice address
4000 LAUREL ST, ANCHORAGE, AK 99508-5333
(907) 729-6300
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-8961
(907) 729-5180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4118
AK
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
04/23/2014
Last updated
10/29/2024
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