Momodoubolong Faitala, in Anchorage, AK - Behavior Technician

Momodoubolong Faitala, is a Behavior Technician based in Anchorage, Alaska. Momodoubolong Faitala is licensed to practice in Alaska (license number RBT-21-196652) and his current practice location is 3105 Lakeshore Dr Ste A101, Anchorage, Alaska. He can be reached at his office (for appointments etc.) via phone at (907) 302-9164.

NPI number for Momodoubolong Faitala is 1144810763 and his current mailing address is Po Box 241224, Anchorage, Alaska. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144810763.

Contact Information

	Momodoubolong Faitala,
	3105 Lakeshore Dr Ste A101, Anchorage, AK 99517-2815
	(907) 302-9164
	Not Available

Healthcare Provider's Profile

Full Name	Momodoubolong Faitala
Gender	Male
Speciality	Behavior Technician
Location	3105 Lakeshore Dr Ste A101, Anchorage, Alaska
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1144810763
Provider Enumeration Date: 01/19/2021
Last Update Date: 12/17/2021

Medical Identifiers

Medical identifiers for Momodoubolong Faitala such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144810763	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	(* (Not Available))	Secondary
106S00000X	Behavior Technician	RBT-21-196652 (Alaska)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Momodoubolong Faitala is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Momodoubolong Faitala, Po Box 241224, Anchorage, AK 99524-1224 Ph: (907) 302-9164	Momodoubolong Faitala, 3105 Lakeshore Dr Ste A101, Anchorage, AK 99517-2815 Ph: (907) 302-9164

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Momodoubolong Faitala, - Counselor in Anchorage, AK