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1023340056
CHARLIE TITUS
FAIRBANKS, AK
NPI
1023340056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-02-01
Last Update Date
2010-02-01
Business Address
Mr. CHARLIE TITUS
122 1ST AVE
FAIRBANKS, AK 99701-4803
Phone number: 907-452-8251
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Mailing Address
Mr. CHARLIE TITUS
180 HUMBLE WAY
FAIRBANKS, AK 99709
Phone number: 907-590-9165
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