Individual
MAGNOLIA MOANANU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3722 PARSONS AVE, ANCHORAGE, AK 99508-1216
(907) 201-9857
Mailing address
3722 PARSONS AVE, ANCHORAGE, AK 99508-1216
(907) 201-9857
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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