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1871836361
IDA SWAN
KOTZEBUE, AK
NPI
1871836361
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-04-03
Last Update Date
2013-04-03
Business Address
-- IDA SWAN
733 2ND AVE
KOTZEBUE, AK 99752-0256
Phone number: 907-442-7640
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Mailing Address
-- IDA SWAN
733 2ND AVE
KOTZEBUE, AK 99752-0256
Phone number:
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