Individual
SHELANA RENEE MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4151 S MEADOW DR, WASILLA, AK 99623-0465
(907) 602-0371
Mailing address
PO BOX 879040, WASILLA, AK 99687-8900
(907) 602-0371
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
101452
AK
Other
Enumeration date
07/07/2021
Last updated
09/14/2021
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