Provider Demographics
NPI:1538835459
Name:CEDIEL, JUAN E
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:E
Last Name:CEDIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SITKA COUNSELING AND PREVENTION
Mailing Address - Street 2:113 METLAKATLA ST.
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835
Mailing Address - Country:US
Mailing Address - Phone:907-747-3636
Mailing Address - Fax:907-747-2702
Practice Address - Street 1:SITKA COUNSELING AND PREVENTION
Practice Address - Street 2:113 METLAKATLA ST.
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835
Practice Address - Country:US
Practice Address - Phone:907-747-3636
Practice Address - Fax:907-747-2702
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172V00000XOther Service ProvidersCommunity Health Worker