| NPI | 1043610892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ELLEN DESRUISSEAU CFO 907-360-1566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 935267) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2025-03-12 |