Individual
KELLY ANDALORO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCII
Contact information
Practice address
3504 INDUSTRIAL AVE, SUITE 220, FAIRBANKS, AK 99701-7376
(907) 388-3221
(907) 459-8201
Mailing address
3504 INDUSTRIAL AVE, SUITE 220, FAIRBANKS, AK 99701-7376
(907) 388-3221
(907) 459-8201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2139
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139
ALASKA COMMISSION FOR BEHAVIORAL HEALTH CERTIFICATION
AK
Enumeration date
12/17/2010
Last updated
01/05/2011
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