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1255996351
SHELLY LYNN NIBLACK
KENAI, AK
NPI
1255996351
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-05-03
Last Update Date
2019-05-03
Business Address
SHELLY LYNN NIBLACK CDC l
10200 KENAI SOUR HWY
KENAI, AK 99611
Phone number: 907-283-3658
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Mailing Address
SHELLY LYNN NIBLACK CDC l
PO BOX 882
KENAI, AK 99611-0882
Phone number: 907-283-3658
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