Provider Demographics
NPI:1760180467
Name:WARD, LINDA RANAE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:RANAE
Last Name:WARD
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 879635
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-9635
Mailing Address - Country:US
Mailing Address - Phone:907-715-4440
Mailing Address - Fax:
Practice Address - Street 1:7335 E PALMER WASILLA HWY STE B109
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7710
Practice Address - Country:US
Practice Address - Phone:907-745-6200
Practice Address - Fax:907-745-6211
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician