Individual
KAYLA ALEXIS LEU CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1521 S CUSHMAN ST, FAIRBANKS, AK 99701-6203
(907) 750-6270
Mailing address
1521 S CUSHMAN ST, FAIRBANKS, AK 99701-6203
(907) 750-6270
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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