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Individual

JACQUELINE OMENITSCH SCURLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
230 E MARYDALE AVE, SOLDOTNA, AK 99669
(907) 262-3119
(907) 262-9290
Mailing address
PO BOX 2949, SOLDOTNA, AK 99669-2949
(240) 674-3191

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
18453
MD
1041C0700X
Clinical Social Worker
Primary
147557
AK

Other

Enumeration date
12/11/2014
Last updated
09/24/2019
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