NPI | 1699355149 |
---|---|
Entity Type | Organization |
Authorized Contact | THERESA R RONCO Billing Manager 907-771-0536 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2021-04-09 |
Last Update Date | 2021-04-09 |