| NPI | 1689193740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE ELAINE BORDER Member 907-230-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK 118148) |
| Enumeration Date | 2017-09-10 |
| Last Update Date | 2024-09-13 |