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Individual

DR. MARJORIE TERESA KYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
4982 ZUKERT AVE, RM 126, JBER, AK 99505
(907) 580-0715
(907) 580-0629
Mailing address
3705 ARCTIC BLVD # 406, ANCHORAGE, AK 99503-5774
(607) 230-2190

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
628
AK
103TC2200X
Clinical Child & Adolescent Psychologist
31369
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1724726
TX
01
628
BOARD OF PSYCHOLOGIST
AK
Enumeration date
06/12/2006
Last updated
10/22/2019
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