Individual
ROBERTA LOUISE GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PDHA I
Contact information
Practice address
7300 A KLAWOCK HOLLIS HIGHWAY, KLAWOCK, AK 99925
(907) 755-4918
(907) 755-4811
Mailing address
PO BOX 69, KLAWOCK, AK 99925-0069
(907) 755-4918
(907) 755-4811
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-071-PDHA I
COMMUNITY HEALTH AIDE PROGRAM CERTIFICATION BOARD - FEDERAL CERTIFICAITON
AK
Enumeration date
04/25/2012
Last updated
04/25/2012
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