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Individual

MR. RICHARD TERRENCE LEE PUCKETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N/A

Contact information

Practice address
533 CENTRAL AVENUE, 638, DILLINGHAM, AK 99576
(907) 843-1191
(000) 000-0000
Mailing address
PO BOX 638, DILLINGHAM, AK 99576-0638
(907) 843-1191
(000) 000-0000

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YA0400X
AK

Other

Enumeration date
03/11/2024
Last updated
03/11/2024
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