Individual
EPHENIA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
829 CHIEF EDDIE HOFFMAN HWY, SUITE 327, BETHEL, AK 99559
(907) 543-2762
(907) 543-3152
Mailing address
PO BOX 528, ATTN: BH DEVELOPMENTAL DISABILITIES, BETHEL, AK 99559-0528
(907) 543-2762
(907) 543-3152
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002447
—
AK
Enumeration date
02/20/2015
Last updated
09/28/2018
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