Provider Demographics
NPI:1891901203
Name:VAIL, ALETA S (LMFT)
Entity Type:Individual
Prefix:
First Name:ALETA
Middle Name:S
Last Name:VAIL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 DENALI ST
Mailing Address - Street 2:SUITE 1608
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2736
Mailing Address - Country:US
Mailing Address - Phone:907-336-4357
Mailing Address - Fax:907-278-3171
Practice Address - Street 1:2550 DENALI ST
Practice Address - Street 2:SUITE 1608
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2736
Practice Address - Country:US
Practice Address - Phone:907-336-4357
Practice Address - Fax:907-278-3171
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK204106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist