Individual
BRENDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 SLOCUM DRIVE, KING COVE, AK 99612-0009
(907) 497-2311
(907) 497-2310
Mailing address
PO BOX 9, KING COVE, AK 99612-0009
(907) 497-2311
(907) 497-2310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2945
AK
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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