Quavon L Bracken
Peer Specialist in Anchorage, AK. Individual provider (NPI-1).
NPI number1558048645
StatusActive
Last updated in NPPESJun 29, 2023
Details
- NPI
- 1558048645
- Entity type
- Individual (NPI-1)
- Name
- Quavon L Bracken
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 29, 2023
- Certification date
- Jun 29, 2023
- Last updated
- Jun 29, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | AK | Yes |
Practice location
704 W 26th Ave Ste 206Anchorage, AK 99503-2532
Phone 907-929-2633
Mailing address
704 W 26th Ave Ste 206Anchorage, AK 99503-2532
Phone 907-929-2633
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