Provider Demographics
NPI:1689282030
Name:ACHWIL, FLORENCE L
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:L
Last Name:ACHWIL
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 1:4423 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2226
Mailing Address - Country:US
Mailing Address - Phone:907-306-5161
Mailing Address - Fax:
Practice Address - Street 1:4423 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2226
Practice Address - Country:US
Practice Address - Phone:907-306-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101343251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services