Provider Demographics
NPI:1326691726
Name:WONHOLA, ADRIAN MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:ADRIAN
Middle Name:MICHELLE
Last Name:WONHOLA
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 130
Mailing Address - Street 2:
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576-0130
Mailing Address - Country:US
Mailing Address - Phone:907-842-5266
Mailing Address - Fax:800-842-3871
Practice Address - Street 1:NEW STUYAHOK TRADITIONAL COUNCIL-WALLACE STREET
Practice Address - Street 2:
Practice Address - City:NEW STUYAHOK
Practice Address - State:AK
Practice Address - Zip Code:99636
Practice Address - Country:US
Practice Address - Phone:907-693-3150
Practice Address - Fax:907-693-3186
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor