Individual
KIRSTEN IRENE SUSORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 FRAM STREET, PETERSBURG, AK 99833
(907) 772-3332
Mailing address
PO BOX 1309, PETERSBURG, AK 99833-1309
(907) 518-4166
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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