| Leap A/v Program | |
|
600 University Ave Ste 3 Fairbanks AK 99709-3651 | |
| (907) 452-2473 | |
| Not Available |
| Full Name | Leap A/v Program |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 600 University Ave Ste 3, Fairbanks, Alaska |
| Authorized Official Name and Position | Lisa Hay (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9074522473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leap A/v Program 600 University Ave Suite 3 Mail: Po Box 82842 Fairbanks AK 99708-2842 Ph: (907) 452-2473 | Leap A/v Program 600 University Ave Ste 3 Fairbanks AK 99709-3651 Ph: (907) 452-2473 |
| NPI Number | 1518195080 |
|---|---|
| Provider Enumeration Date | 06/23/2009 |
| Last Update Date | 06/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518195080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 921 (Alaska) | Primary |
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