Provider Demographics
NPI:1164145249
Name:IGUEL, TRINI MARIE CONCEPCION
Entity Type:Individual
Prefix:
First Name:TRINI MARIE
Middle Name:CONCEPCION
Last Name:IGUEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751087
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99775-1087
Mailing Address - Country:US
Mailing Address - Phone:410-982-7333
Mailing Address - Fax:
Practice Address - Street 1:1634 TANANA LOOP 303
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99775-0001
Practice Address - Country:US
Practice Address - Phone:410-982-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical