Provider Demographics
NPI:1023694148
Name:HARBER, VERONICA (LMT)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:HARBER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S KNIK GOOSE BAY RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8063
Mailing Address - Country:US
Mailing Address - Phone:210-379-2883
Mailing Address - Fax:907-308-5953
Practice Address - Street 1:1901 N HEMMER RD STE 213
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-9690
Practice Address - Country:US
Practice Address - Phone:907-232-7186
Practice Address - Fax:907-308-5953
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK168852225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK168852OtherLMT LICENSE