Individual
MARIA MARIANE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6100
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
(907) 543-6100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0150
—
AK
Enumeration date
06/14/2013
Last updated
06/14/2013
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