| NPI | 1407575236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJORIE TERESA KYLE Psychologist 907-230-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |