Individual
MRS. KRYSTLE VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 PARKWAY DR, ANCHORAGE, AK 99504-2834
(907) 753-8888
Mailing address
1616 PARKWAY DR, ANCHORAGE, AK 99504-2834
(907) 753-8888
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
100852
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
AK
Enumeration date
03/08/2011
Last updated
03/08/2011
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