Individual
NEVADA RAE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
926 ASPEN ST, FAIRBANKS, AK 99709-5501
(907) 371-1300
Mailing address
4020 FOLKER ST, ANCHORAGE, AK 99508-5321
(907) 371-1300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
135820
AK
1041C0700X
Clinical Social Worker
Primary
161071
AK
Other
Enumeration date
07/19/2019
Last updated
03/04/2022
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