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Individual

DR. KYLE RAYMOND KWON DEXTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
122 1ST AVE STE 400, FAIRBANKS, AK 99701-4871
(907) 452-8251
Mailing address
214 DRIVEWAY ST, FAIRBANKS, AK 99701-2806
(603) 834-5929

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
164185
AK
103TA0400X
Addiction (Substance Use Disorder) Psychologist
164185
AK
103TC0700X
Clinical Psychologist
022959
NY

Other

Enumeration date
10/11/2018
Last updated
11/30/2022
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