Individual
CLARA R SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CT
Contact information
Practice address
TETLIN VILLAGE ROAD, TETLIN, AK 99780
(907) 324-2136
(907) 324-2136
Mailing address
PO BOX 597, TOK, AK 99780-0597
(907) 324-2136
(907) 883-2136
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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