| NPI | 1013424225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DEVON MCCORMICK Owner 907-750-7169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AK CSWS1053) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-04-04 |