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Individual

MS. SEVILLA INGERSOLL LOVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6501 TESHLAR DR, ANCHORAGE, AK 99507-2218
(907) 887-6269
(907) 887-6269
Mailing address
6501 TESHLAR DR, ANCHORAGE, AK 99507-2218
(907) 887-6269
(907) 887-6269

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
AA702
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AA702
STATE OF ALASKA
AK
05
DA4460
AK
05
MH4238
AK
Enumeration date
08/05/2007
Last updated
04/29/2021
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