Individual
MRS. DENISE BURTON STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
717 E REZANOF DR, KODIAK, AK 99615-6416
(907) 481-2400
Mailing address
500B CAPE DECISION ST, KODIAK, AK 99615-6817
(907) 512-3059
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
975
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
975
ALASKA LCSW LICENSE NUMBER
AK
01
—
C005352
NC LCSW LICENSE NUMBER
NC
Enumeration date
10/04/2006
Last updated
03/29/2011
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