Individual
MICHAEL D KOLASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
600 UNIVERSITY AVE, STE 5, FAIRBANKS, AK 99709
(907) 347-1989
(907) 459-8201
Mailing address
PO BOX 72461, FAIRBANKS, AK 99707-2461
(907) 347-1989
(907) 459-8201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
122176
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122176
PROFESSIONAL COUNSELOR
AK
Enumeration date
08/28/2017
Last updated
02/04/2020
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