| NPI | 1730779968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOAH SHIELDS President, Provider 907-252-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-01-21 |