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NPI Code Detail

MEDICARE: WANDA SUE NAFFZIGER

MEDICARE: WANDA SUE NAFFZIGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
4251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669763579
Entity Type Code : Individual
Provider Name (Legal Business Name) : WANDA SUE NAFFZIGER
Provider Business Mailing Address
First Line : 2727 S BARNETTE ST
Second Line :
City : FAIRBANKS
State : AK
Zip : 99701-6826
Country : US
Telephone Number : 907-374-1958
Fax Number :
Provider Business Practice Location Address
First Line : 1423 PEGER RD
Second Line :
City : FAIRBANKS
State : AK
Zip : 99709-5169
Country : US
Telephone Number : 907-371-1300
Fax Number : 907-371-1386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2011
Last Update Date : 02/10/2021

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Directions to “ WANDA SUE NAFFZIGER ” Practice Location

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