Individual
PHILLIP R LAZENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 N BINKLEY ST, SOLDOTNA, AK 99669-7500
(907) 714-4521
(907) 260-4063
Mailing address
PO BOX 2127, SOLDOTNA, AK 99669-2127
(907) 398-1161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
132467
AK
101YP2500X
Professional Counselor
Primary
132467
AK
Other
Enumeration date
05/29/2019
Last updated
07/27/2021
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