Individual
TERESA ANN TANGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12528 HAWK LN, HOUSTON, AK 99694-1252
(907) 892-6944
Mailing address
PO BOX 299136, WASILLA, AK 99629-9136
(907) 892-6944
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
737926
AK
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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