person
Amanda Paulette Gannon, CDC-I
Addiction (Substance Use Disorder) Counselor in Ketchikan, Alaska
NPI 1285234419

Amanda Paulette Gannon is an Addiction (Substance Use Disorder) Counselor based in Ward Cove, AK and is specialized in Addiction (Substance Use Disorder). Amanda Paulette Gannon practices in Ketchikan, AK and has the professional credentials of CDC-I. The NPI Number for Amanda Paulette Gannon is 1285234419 and holds a License No. 4580 (Alaska).

The current practice location address for Amanda Paulette Gannon is 201 Deermount St Fl 2, Ketchikan, AK and can be reached out via phone at 907-228-9203 and via fax at 800-590-3277. You can also correspond with Amanda Paulette Gannon through the mailing address at PO BOX 519, WARD COVE, AK - 99928-0519 (mailing address contact number: 512-423-8240).

Location: 201 Deermount St Fl 2, Ketchikan, AK, 99928-0519
person
Provider Profile Details
NPI Number
1285234419
Provider Name
Amanda Paulette Gannon
Credential
CDC-I
Provider Entity Type
Individual
Gender
Female
Address
201 Deermount St Fl 2, Ketchikan, AK, 99928-0519
Phone Number
907-228-9203
Fax Number
800-590-3277
Provider Enumeration Date
10/27/2020
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1366719759 05 AK
institution
Provider Business Practice Location Address Details
Address
201 Deermount St Fl 2
City
State
Zip
99901-6649
Phone Number
907-228-9203
Fax Number
800-590-3277
person
Provider Business Mailing Address Details
Address
201 Deermount St Fl 2
City
State
Zip
99901-6649
Phone Number
907-228-9203
Fax Number
800-590-3277
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
4580 (Alaska)
Definition
Definition to come...
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