Individual
DEELA LYNN COUTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
460 RIDGECREST, SUITE 214, BETHEL, AK 99559
(907) 543-6000
(907) 543-6008
Mailing address
P.O. BOX 528, BETHEL, AK 99559
(907) 543-6000
(907) 543-1276
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002573
—
AK
05
—
CMG528
—
AK
Enumeration date
06/25/2012
Last updated
03/10/2014
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