NPI 1508121096 · live from the CMS NPI Registry
Borealis Behavioral Health
Marriage & Family Therapist in Palmer, AK. National Provider Identifier 1508121096, active.
NPI record
| NPI | 1508121096 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 634 S Bailey St, Suite 207, Palmer, AK 99645 |
| Practice phone | 907-745-7080 |
| Enumerated | July 10, 2012 |
| Last updated | July 10, 2012 |
| Authorized official | Jana Miner-Collins, Member |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist | 106H00000X | 86 (AK) |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | 241 (AK) |
| Marriage & Family Therapist primary | 106H00000X | 77 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.