SHANNON RICHARD LUSTER

FAIRBANKS, AK
NPI1073821708
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2010-09-15
Last Update Date2010-09-15
Business Address
Mr. SHANNON RICHARD LUSTER B.A.
3830 S CUSHMAN ST
FAIRBANKS, AK 99701-7530
Phone number: 907-452-1575
Mailing Address
Mr. SHANNON RICHARD LUSTER B.A.
PO BOX 60863
FAIRBANKS, AK 99706-0863
Phone number: 907-474-4908