Individual
KYLE MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1709 BRAGAW ST, ANCHORAGE, AK 99508-3436
(907) 346-2101
Mailing address
6222 E 12TH AVE APT C1, ANCHORAGE, AK 99504-2363
(907) 360-4655
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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