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EMILY DIANE ICE BCABA

Behavioral Analyst

Fairbanks, Alaska

Provider NPI: 1942452651

Provider Information:
 EMILY DIANE ICE BCABA
Gender: F
Sole Proprietor


Practice Location:
3060 AMBER AVE  FAIRBANKS, AK 99709 US
Tel: 907-347-8115  Fax: --

Business Mailing Address:
3060 AMBER AVE  FAIRBANKS, AK 99709 US
Tel: 907-347-8115  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103K00000X










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