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Individual

JENNIFER BOURNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7010 E BOGARD RD BLDG 2, WASILLA, AK 99654-4711
(907) 373-4732
(907) 746-4749
Mailing address
PO BOX 876741, WASILLA, AK 99687-6741
(907) 373-4732
(907) 746-4749

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
02/03/2022
Last updated
02/03/2022
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