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Individual

KENT CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2211 ARCA DR, ANCHORAGE, AK 99508-3462
(907) 646-5708
Mailing address
2211 ARCA DR, ANCHORAGE, AK 99508-3462

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
AK
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AK7022602
AK
Enumeration date
08/09/2018
Last updated
08/09/2018
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