Individual
KYLA FERMOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
835 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6862
Mailing address
PO BOX 528, BETHEL, AK 99559-0528
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
07/16/2019
Last updated
07/16/2019
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