Individual
MRS. JUANITA SERENA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4034 REKA L5, ANCHORAGE, AK 99508
(907) 569-5033
(907) 569-5033
Mailing address
PO BOX 141795, ANCHORAGE, AK 99514-1795
(907) 569-5033
(907) 569-5033
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
278361
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CM5272
—
AK
Enumeration date
03/12/2007
Last updated
07/08/2007
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