Individual
JENNIFER ROSE THEULEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
(907) 729-8880
Mailing address
7033 E TUDOR RD, ANCHORAGE, AK 99507-1262
(907) 729-6801
(907) 729-5180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
AK
104100000X
Social Worker
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
04/28/2026
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