Individual
COLLEEN ROBERTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7300
Mailing address
508 UPLAND ST, KENAI, AK 99611-8026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
216406
AK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712755
—
AK
Enumeration date
04/22/2019
Last updated
10/23/2024
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