Organization
SACRED SPACE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHANA GIBNEY L.C.S.W. (OWNER)
(907) 929-4325
Entity
Organization
Contact information
Practice address
4325 LAUREL ST, SUITE # 285, ANCHORAGE, AK 99508-5364
(907) 929-4325
Mailing address
4325 LAUREL ST, SUITE # 285, ANCHORAGE, AK 99508-5364
(907) 929-4325
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1349
AK
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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