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1184277808
STAYSHA KELLY
FAIRBANKS, AK
NPI
1184277808
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-07-22
Last Update Date
2019-07-22
Business Address
STAYSHA KELLY
542 4TH AVE STE B101
FAIRBANKS, AK 99701-4707
Phone number: 907-750-9589
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Mailing Address
STAYSHA KELLY
1022 AKIAK AVE
FAIRBANKS, AK 99701-1417
Phone number: 907-750-9589
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