Provider Demographics
NPI:1952953994
Name:HAZEN, RITA M (BHS, CDCII)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:M
Last Name:HAZEN
Suffix:
Gender:F
Credentials:BHS, CDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 GAMBELL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-4664
Mailing Address - Country:US
Mailing Address - Phone:907-333-4343
Mailing Address - Fax:907-333-4383
Practice Address - Street 1:1231 GAMBELL ST STE 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-4664
Practice Address - Country:US
Practice Address - Phone:907-333-4343
Practice Address - Fax:907-333-4383
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator