Individual
JORDAN DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 S CUSHMAN ST, FAIRBANKS, AK 99701-7516
(907) 452-6251
(907) 456-4849
Mailing address
2315 ONYX RD, NORTH POLE, AK 99705-6210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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