Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1538720800 |
---|---|
Provider Name | Luke Hobbs |
First Address | Anchorage, AK 99501-5434 |
Second Address | Anchorage, AK 99501-5434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 26/06/2019 |