Individual
SUSIE SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 154, GALENA, AK 99741-0154
(907) 656-7215
(907) 656-7215
Mailing address
200 1ST AVE, FAIRBANKS, AK 99701-4805
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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