Provider Demographics
NPI:1265863427
Name:ALASKA NEUROPSYCHOLOGICAL AND BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:ALASKA NEUROPSYCHOLOGICAL AND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKARM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-699-7524
Mailing Address - Street 1:600 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 2 B
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-3651
Mailing Address - Country:US
Mailing Address - Phone:907-699-7524
Mailing Address - Fax:
Practice Address - Street 1:600 UNIVERSITY AVE
Practice Address - Street 2:SUITE 2 B
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-3651
Practice Address - Country:US
Practice Address - Phone:907-699-7524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health