YANNICK MALCOLM STALLWORTH

ANCHORAGE, AK
NPI1588279301
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2020-09-09
Last Update Date2020-09-09
Business Address
YANNICK MALCOLM STALLWORTH
1709 BRAGAW ST
ANCHORAGE, AK 99508-3436
Phone number: 907-290-4773
Mailing Address
YANNICK MALCOLM STALLWORTH
1520 ELCADORE DR APT 133
ANCHORAGE, AK 99507-4750
Phone number: 907-290-4773