Healthcare Provider Details

I. General information

NPI: 1528682093
Provider Name (Legal Business Name): TIERRA ELIZABETH HARFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 HESTERBERG RD
EAGLE RIVER AK
99577-9023
US

IV. Provider business mailing address

143 E 9TH AVE
ANCHORAGE AK
99501-3618
US

V. Phone/Fax

Practice location:
  • Phone: 907-694-9511
  • Fax:
Mailing address:
  • Phone: 907-276-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: