Individual provider · Type 1 NPI

Jalon Alexander McCullough

Addiction (Substance Use Disorder) Counselor · Fairbanks, AK

NPI number 1104438365 Active

Practice location

542 4th Ave Ste B-101
Fairbanks, AK 99701-4707

Call (907) 374-1097 Map

Fax (907) 374-1062

Mailing address

PO Box 73004
Fairbanks, AK 99707-3004

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104438365

Jalon Alexander McCullough's National Provider Identifier is 1104438365, issued on Aug 19, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fairbanks, AK. The record was last updated on Aug 19, 2020.