Individual
MARY SHANNON WALDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 130, DILLINGHAM, AK 99576-0130
(907) 842-5201
Mailing address
PO BOX 1503, DILLINGHAM, AK 99576-1503
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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