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1376986802
LISA ROOT
FAIRBANKS, AK
NPI
1376986802
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CO 012375)
Enumeration Date
2013-04-15
Last Update Date
2013-04-15
Business Address
-- LISA ROOT Psyd
442 HAGELBARGER AVE
FAIRBANKS, AK 99712-1917
Phone number: 907-350-4353
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Mailing Address
-- LISA ROOT Psyd
442 HAGELBARGER AVE
FAIRBANKS, AK 99712-1917
Phone number: 907-350-4353
Copy
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