Individual
LACAGE MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2521 E MOUNTAIN VILLAGE DR STE F, WASILLA, AK 99654-7373
(907) 290-3760
(907) 631-0647
Mailing address
3860 S TRADEWINDS CIR, WASILLA, AK 99623-9410
(810) 986-7053
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/06/2019
Last updated
07/06/2019
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