Doctor Name: | SUSAN J HADACEK |
NPI Number: | 1225306368 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC |
License Number: | 213 |
Business Practice Address: | 11940 Business Blvd Ste 205 Eagle River, AK - 995777742 |
Business Phone Number: | 9073309188 |
Business Fax Number: | |
Mailing Address: | 11940 Business Blvd Ste 205, EAGLE RIVER |
State: | AK |
Postal Code: | 995777742 |
Phone Number: | 9073309188 |
Fax Number: | |
NPI Enumeration Date: | 12/04/2011 |
NPI Last Update Date: | 12/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 213 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |