Organization
LIGHTED PATH THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD ERIC HOLL LPC (OWNER)
(907) 312-1202
Entity
Organization
Contact information
Practice address
901 N. LEATHERLEAF LOOP SUITE 103, WASILLA, AK 99654
(907) 312-1202
(855) 553-8083
Mailing address
PO BOX 871336, WASILLA, AK 99654
(907) 312-1202
(855) 553-8083
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
809
AK
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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