Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 554 | AK |
Y | 103T00000X | Psychologist | 554 | AK |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | AK |
NPI | 1245203918 |
---|---|
Provider Name | Dr. Kristie Kay Sellers |
First Address | Soldotna, AK 99669-2803 |
Second Address | Soldotna, AK 99669-7500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 20/04/2021 |