Provider Demographics
NPI:1275149098
Name:KENAI THERAPUETICS
Entity Type:Organization
Organization Name:KENAI THERAPUETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DUNVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:907-769-1301
Mailing Address - Street 1:PO BOX 1563
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-1563
Mailing Address - Country:US
Mailing Address - Phone:907-769-1301
Mailing Address - Fax:
Practice Address - Street 1:234 4TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664
Practice Address - Country:US
Practice Address - Phone:907-769-1301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)