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General NPI Number Information
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NPI Number | 1053974725
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Entity Type | Individual
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Provider Name | MS. JILL RORAFF
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Gender | Female
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 950 S SNODGRASS DR
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City | PALMER
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State | AK
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Zip | 99645-9149
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Country | US
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Telephone | 907-822-5079
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 876741
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City | WASILLA
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State | AK
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Zip | 99687-6741
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Country | US
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Telephone | 907-982-2507
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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