Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003423708 |
---|---|
Provider Name | Katie Ogin |
First Address | Anchorage, AK 99517-1397 |
Second Address | Eagle River, AK 99577-9013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2020 |
Last Update Date | 26/09/2020 |