Organization
MIND, BODY AND SPIRIT COUNSELING & CONSULTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK PONZIANO JR. LPC, MAC (MANAGER)
(773) 981-0620
Entity
Organization
Contact information
Practice address
2025 BLUEBERRY ST APT 2, FAIRBANKS, AK 99701-6589
(773) 981-0620
Mailing address
2025 BLUEBERRY ST APT 2, FAIRBANKS, AK 99701-6589
(773) 981-0620
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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