| NPI | 1477743532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M RONCO Billing Manager 907-632-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-25 |