Provider Demographics
NPI:1851423404
Name:KOKRINE, MARIE (BSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:KOKRINE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:395 EAGLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99712-1230
Mailing Address - Country:US
Mailing Address - Phone:907-459-3800
Mailing Address - Fax:907-459-3810
Practice Address - Street 1:122 1ST AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4803
Practice Address - Country:US
Practice Address - Phone:907-459-3800
Practice Address - Fax:907-459-3810
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health