Provider Demographics
NPI:1598371106
Name:MCCOTTER, SONDRA M
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:M
Last Name:MCCOTTER
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 1:13740 ARNE ERICKSON CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3952
Mailing Address - Country:US
Mailing Address - Phone:907-382-8595
Mailing Address - Fax:
Practice Address - Street 1:1236 G ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-4353
Practice Address - Country:US
Practice Address - Phone:907-382-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPCOP844101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional