Healthcare Provider Details

I. General information

NPI: 1124159876
Provider Name (Legal Business Name): DENNIS EDWARD HOJNA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CUSHMAN STREET SUITE 5
FAIRBANKS AK
99701
US

IV. Provider business mailing address

PO BOX 84156
FAIRBANKS AK
99708-4156
US

V. Phone/Fax

Practice location:
  • Phone: 907-712-7485
  • Fax:
Mailing address:
  • Phone: 907-712-7485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSWS372
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: