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Individual

MICHAEL WILLIAM JOHNDRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
634 S BAILEY ST, SUITE 207, PALMER, AK 99645-6330
(907) 745-7080
(907) 745-6263
Mailing address
634 S BAILEY ST, SUITE 207, PALMER, AK 99645-6330
(907) 745-7080
(907) 745-6263

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
86
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2383280
CIGNA
01
421545189
BLUE GROUP GROUP BILLING
AK
01
45-5503677
COMMERICAL INSURANCE
01
561028000
MAGELLAN
AK
05
MH9931
AK
Enumeration date
01/04/2007
Last updated
09/06/2012
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