| NPI | 1629013065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE FISSORI CFO 907-264-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AK 54965) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: AK 435) | |
| 103T00000X Psychologist (Licence: AK 2817) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2008-12-11 |