| NPI | 1326152711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI H FULLER Owner/Partner 907-561-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0200X Psychologist Forensic | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103T00000X Psychologist | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 1041C0700X Social Worker Clinical (Licence: AK 1022) | |
| 1041C0700X Social Worker Clinical (Licence: AK 1023) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-03-22 |