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Individual

COLLEEN MCNULTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
701 NORTH FOREST ST., KENAI, AK 99611
(907) 335-2052
(907) 335-2051
Mailing address
701 NORTH FOREST ST., KENAI, AK 99611
(907) 335-2052
(907) 335-2051

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
101027
AK

Other

Enumeration date
01/10/2014
Last updated
01/10/2014
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