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1235532714
CRYSTAL LEAKE
FAIRBANKS, AK
NPI
1235532714
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AK 806)
Enumeration Date
2014-09-29
Last Update Date
2014-09-29
Business Address
-- CRYSTAL LEAKE LPC
3504 INDUSTRIAL AVE STE 214
FAIRBANKS, AK 99701-7390
Phone number: 907-452-4673
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Mailing Address
-- CRYSTAL LEAKE LPC
3504 INDUSTRIAL AVE STE 214
FAIRBANKS, AK 99701-7390
Phone number: 907-452-4673
Copy
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