Provider Demographics
NPI:1639763022
Name:BRECHT, KIERRA
Entity Type:Individual
Prefix:
First Name:KIERRA
Middle Name:
Last Name:BRECHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7449 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1916
Mailing Address - Country:US
Mailing Address - Phone:907-250-8334
Mailing Address - Fax:
Practice Address - Street 1:17025 SNOWMOBILE LN
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7044
Practice Address - Country:US
Practice Address - Phone:907-696-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171157103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical