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Mary Susan Tieden
Mental Health Counselor in Petersburg, Alaska
NPI 1508188582

Mary Susan Tieden is a Mental Health Counselor based in Petersburg, AK and is specialized in Mental Health. Mary Susan Tieden practices in Petersburg, AK. The NPI Number for Mary Susan Tieden is 1508188582 and holds a License No. 293 (Alaska).

The current practice location address for Mary Susan Tieden is 201 North Nordic Drive, Petersburg, AK and can be reached out via phone at 907-772-3332 and via fax at 888-858-8850.

Location: 201 North Nordic Drive, Petersburg, AK, 99833-1309
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508188582
Provider Name
Mary Susan Tieden
Credential
Provider Entity Type
Individual
Gender
Female
Address
201 North Nordic Drive, Petersburg, AK, 99833-1309
Phone Number
907-772-3332
Fax Number
888-858-8850
Provider Enumeration Date
02/18/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MH1413 05 AK
institution
Provider Business Practice Location Address Details
Address
201 North Nordic Drive
City
Petersburg
State
Alaska
Zip
99833
Phone Number
907-772-3332
Fax Number
888-858-8850
person
Provider Business Mailing Address Details
Address
201 North Nordic Drive
City
Petersburg
State
Alaska
Zip
99833
Phone Number
907-772-3332
Fax Number
888-858-8850
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
293 (Alaska)
Definition
Definition to come...
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