Individual
WANDA SUE NAFFZIGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 PEGER RD, FAIRBANKS, AK 99709-5169
(907) 371-1300
(907) 371-1386
Mailing address
2727 S BARNETTE ST, FAIRBANKS, AK 99701-6826
(907) 374-1958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
04/26/2011
Last updated
02/10/2021
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