| NPI | 1467801548 |
|---|---|
| Doing Business As | CHANGING TIDES |
| Entity Type | Organization |
| Authorized Contact | KIMBER RAYE OLSON Owner/Clinical Director 907-903-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AK 447) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |