Amos Banham
Counselor, Addiction (Substance Use Disorder) in Palmer, AK. Individual provider (NPI-1).
NPI number1033877873
StatusActive
Last updated in NPPESAug 16, 2024
Details
- NPI
- 1033877873
- Entity type
- Individual (NPI-1)
- Name
- Amos Banham
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 29, 2021
- Certification date
- Aug 16, 2024
- Last updated
- Aug 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | AK | Yes |
| 175T00000X | Peer Specialist | – | – |
Practice location
950 S Snodgrass DrPalmer, AK 99645-9750
Phone 907-373-4732 · Fax 907-746-4749
Mailing address
Po Box 876741Wasilla, AK 99687-6741
Phone 907-373-4732 · Fax 907-746-4749
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