person
Susie Katherine Mitkov
Addiction (Substance Use Disorder) Counselor in Fairbanks, Alaska
NPI 1669105375

Susie Katherine Mitkov is an Addiction (Substance Use Disorder) Counselor based in Fairbanks, AK and is specialized in Addiction (Substance Use Disorder). Susie Katherine Mitkov practices in Fairbanks, AK. The NPI Number for Susie Katherine Mitkov is 1669105375 and holds a License No. (Alaska).

The current practice location address for Susie Katherine Mitkov is 1521 S Cushman St, Fairbanks, AK and can be reached out via phone at 907-452-8251 and via fax at 907-459-3842.

Location: 1521 S Cushman St, Fairbanks, AK, 99701-6203
person
Provider Profile Details
NPI Number
1669105375
Provider Name
Susie Katherine Mitkov
Credential
Provider Entity Type
Individual
Gender
Female
Address
1521 S Cushman St, Fairbanks, AK, 99701-6203
Phone Number
907-452-8251
Fax Number
907-459-3842
Provider Enumeration Date
07/08/2022
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
5191621 01 AK DRIVER'S LICENSE
institution
Provider Business Practice Location Address Details
Address
1521 S Cushman St
City
State
Zip
99701-6203
Phone Number
907-452-8251
Fax Number
907-459-3842
person
Provider Business Mailing Address Details
Address
1521 S Cushman St
City
State
Zip
99701-6203
Phone Number
907-452-8251
Fax Number
907-459-3842
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
()
Definition
Definition to come...
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