Organization
NORTHERN PSYCHOLOGY RESOURCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE DAWN BOCK PHD (OWNER)
(907) 335-4466
Entity
Organization
Contact information
Practice address
215 FIDALGO AVE, KENAI, AK 99611-7751
(307) 335-4466
(907) 335-4467
Mailing address
PO BOX 1487, KENAI, AK 99611-1487
(907) 335-4466
(907) 335-4467
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
561
AK
103TC0700X
Clinical Psychologist
Primary
561
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427095900
INDIVIDUAL NPI
AK
05
—
PS0561
—
AK
Enumeration date
02/07/2007
Last updated
09/11/2025
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