Individual
SHANNON RENEE FRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7300
Mailing address
PO BOX 988, KENAI, AK 99611-0988
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AK
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1739311
—
AK
Enumeration date
06/12/2023
Last updated
06/19/2025
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