Malissia Willowdawn Anderson, MHT

NPI #1467899625 in Fairbanks, Alaska

Provider Information

NPI Number: 1467899625
Entity Type: Individual
Name: Malissia Willowdawn Anderson, MHT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Credential: MHT
Enumeration Date: May 29, 2013
Last Updated: Nov 16, 2020

Practice Location

Address: 3101 LATHROP STREET
City: Fairbanks
State: Alaska
ZIP Code: 99701
Phone: (907) 459-4700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Behavior Technician	106S00000X	Primary

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