Individual
MEGAN RUSSELL-LICATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 DENALI ST., STE. 1608, ANCHORAGE, AK 99503
(907) 242-9541
Mailing address
1617 LOGAN ST., ANCHORAGE, AK 99508-3237
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
113123
AK
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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