Individual
MS. BROOKE ANN AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2524 FIRST AVE, KETCHIKAN, AK 99901-5804
(907) 617-6145
(907) 885-6613
Mailing address
PO BOX 7475, KETCHIKAN, AK 99901-2475
(907) 617-6145
(907) 885-6613
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021118
—
AK
05
—
1584706
—
AK
Enumeration date
11/23/2020
Last updated
11/23/2020
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