Provider Demographics
NPI:1114298296
Name:NORTON SOUND HEALTH CORPORATION
Entity Type:Organization
Organization Name:NORTON SOUND HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:BIANCA
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:907-443-3344
Mailing Address - Street 1:P.O.BOX 966
Mailing Address - Street 2:306 WEST 5TH AVE
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3344
Mailing Address - Fax:907-443-5915
Practice Address - Street 1:306 WEST 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-9905
Practice Address - Country:US
Practice Address - Phone:907-443-3344
Practice Address - Fax:907-443-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005140251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health