Individual
LETITIA WYCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8440 BLACKBERRY ST, ANCHORAGE, AK 99502-5327
(907) 360-2126
Mailing address
7349 BRANCHE DR, ANCHORAGE, AK 99518-2573
(907) 360-2126
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
101185
AK
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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