| Mind, Body And Spirit Counseling & Consultation Llc | |
|
2025 Blueberry St Apt 2 Fairbanks AK 99701-6589 | |
| (773) 981-0620 | |
| Not Available |
| Full Name | Mind, Body And Spirit Counseling & Consultation Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2025 Blueberry St Apt 2, Fairbanks, Alaska |
| Authorized Official Name and Position | Frank Ponziano (MANAGER) |
| Authorized Official Contact | 7739810620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind, Body And Spirit Counseling & Consultation Llc 2025 Blueberry St Apt 2 Fairbanks AK 99701-6589 Ph: (773) 981-0620 | Mind, Body And Spirit Counseling & Consultation Llc 2025 Blueberry St Apt 2 Fairbanks AK 99701-6589 Ph: (773) 981-0620 |
| NPI Number | 1205401809 |
|---|---|
| Provider Enumeration Date | 05/25/2021 |
| Last Update Date | 05/25/2021 |
| Certification Date | 05/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205401809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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