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1588279301
YANNICK MALCOLM STALLWORTH
ANCHORAGE, AK
NPI
1588279301
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-09-09
Last Update Date
2020-09-09
Business Address
YANNICK MALCOLM STALLWORTH
1709 BRAGAW ST
ANCHORAGE, AK 99508-3436
Phone number: 907-290-4773
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Mailing Address
YANNICK MALCOLM STALLWORTH
1520 ELCADORE DR APT 133
ANCHORAGE, AK 99507-4750
Phone number: 907-290-4773
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