Individual
MARY KAY VELLUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 6TH ST, JUNEAU, AK 99801-1020
(907) 463-6149
Mailing address
419 6TH ST, JUNEAU, AK 99801-1020
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM33501
—
AK
Enumeration date
03/27/2007
Last updated
07/09/2007
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