NPI | 1376981696 |
---|---|
Entity Type | Organization |
Authorized Contact | CARL JOHNSON Co Owner/Manager 907-456-1434 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 761) |
Enumeration Date | 2013-06-08 |
Last Update Date | 2014-03-03 |