Malissia Willowdawn Anderson, MHT is a
Behavior Technician based in Fairbanks, Alaska. Malissia Willowdawn Anderson is licensed to practice in * (Not Available) (license number ) and her current practice location is
3101 Lathrop Street, Fairbanks, Alaska. She can be reached at her office (for appointments etc.) via phone at
(907) 459-4700.
NPI number for Malissia Willowdawn Anderson is 1467899625 and her current mailing address is 3101 Lathrop St, Fairbanks, Alaska. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1467899625.
Healthcare Provider's Profile
| Full Name | Malissia Willowdawn Anderson |
|---|
| Gender | Female |
|---|
| Speciality | Behavior Technician |
|---|
| Location | 3101 Lathrop Street, Fairbanks, Alaska |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1467899625
- Provider Enumeration Date: 05/29/2013
- Last Update Date: 11/16/2020
Medical Identifiers
Medical identifiers for Malissia Willowdawn Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1467899625 | NPI | - | NPPES |
| MH3237 | Medicaid | AK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Malissia Willowdawn Anderson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Malissia Willowdawn Anderson, MHT
3101 Lathrop St,
Fairbanks, AK 99701-7426
Ph: (907) 459-4700 | Malissia Willowdawn Anderson, MHT
3101 Lathrop Street,
Fairbanks, AK 99701
Ph: (907) 459-4700 |
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