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1407400807
JASON CARLOS EDWIN-MATOS
FAIRBANKS, AK
NPI
1407400807
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2019-07-25
Last Update Date
2019-07-25
Business Address
JASON CARLOS EDWIN-MATOS
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number: 907-459-4700
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Mailing Address
JASON CARLOS EDWIN-MATOS
1825 MARIKA RD
FAIRBANKS, AK 99709-5521
Phone number:
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