Doctor Name: | MR. MATTHEW R SENA |
NPI Number: | 1023409828 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 919 |
Business Practice Address: | 926 Aspen St Fairbanks, AK - 997095501 |
Business Phone Number: | 9074518208 |
Business Fax Number: | 9074518207 |
Mailing Address: | 926 Aspen St, FAIRBANKS |
State: | AK |
Postal Code: | 997095501 |
Phone Number: | 9074518208 |
Fax Number: | 9074518207 |
NPI Enumeration Date: | 02/15/2015 |
NPI Last Update Date: | 02/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 919 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |