Individual
BROCK FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
(907) 350-3685
Mailing address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
191410
AK
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/19/2020
Last updated
10/25/2023
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