| NPI | 1578046322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DERUYTER President 907-451-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |