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1063018562
AMANDA IVERSON
KETCHIKAN, AK
NPI
1063018562
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2020-12-09
Last Update Date
2021-02-09
Business Address
AMANDA IVERSON
3356 DALE ST
KETCHIKAN, AK 99901-5626
Phone number: 907-225-7825
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Mailing Address
AMANDA IVERSON
721 STEDMAN ST
KETCHIKAN, AK 99901-6632
Phone number: 907-225-7825
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