| NPI | 1003352998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA WELLER Licensed Professional Counselor 907-317-7136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: AK 0012422) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-01-16 |