Ethan John Ilmar
Day Training/Habilitation Specialist in Bethel, AK. Individual provider (NPI-1).
NPI number1982125753
StatusActive
Last updated in NPPESJul 3, 2017
Details
- NPI
- 1982125753
- Entity type
- Individual (NPI-1)
- Name
- Ethan John Ilmar
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 3, 2017
- Last updated
- Jul 3, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
Practice location
839 Chief Eddie Hoffman HwyBethel, AK 99559
Phone 907-543-2740 · Fax 907-543-6729
Mailing address
P.O. Box 528Attn: Bh Malone Home Program
Bethel, AK 99559
Phone 907-543-2740 · Fax 907-543-6729
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All 102 Day Training/Habilitation Specialist providers in Bethel · All 1,456 providers in Bethel
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