Individual
CODI NICOLE HORNBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3520 INDUSTRIAL AVE, FAIRBANKS, AK 99701-7376
(907) 378-8841
Mailing address
PO BOX 70203, FAIRBANKS, AK 99707-0203
(907) 378-8841
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/22/2019
Last updated
09/03/2025
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