NPI 1164163259
Alaska Counselor Lpc
Practice location
- Address
- 1200 Tongass Ave, Ketchikan, AK 99901-6136
- Phone
- (907) 220-6090
- Mailing address
- 410 Tower Rd, Ketchikan, AK 99901-5357
Authorised official
- Name
- Ruth Bullock
- Title
- Owner
- Phone
- (907) 220-6090
Registered specialties
Community/Behavioral Health Agency
Primary
Registry record
- NPI
- 1164163259
- Entity type
- Organization
- NPI issued
- 5 Apr 2022
- Record last updated
- 5 Apr 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.