Provider Demographics
NPI:1992357065
Name:STURM, JOHN CHRISTIAN (BCBA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:STURM
Suffix:
Gender:M
Credentials:BCBA
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 211563
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-1563
Mailing Address - Country:US
Mailing Address - Phone:907-891-1012
Mailing Address - Fax:
Practice Address - Street 1:7013 SATURN CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4564
Practice Address - Country:US
Practice Address - Phone:907-891-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK137844103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst