Individual
KIRSTEN MARIE PETRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CDC II
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7670
Mailing address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(307) 631-7670
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3155
AK
1041C0700X
Clinical Social Worker
Primary
213013
AK
Other
Enumeration date
06/12/2020
Last updated
07/29/2024
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