Provider Demographics
NPI:1811204498
Name:JUNKO K. TAKAGI
Entity type:Organization
Organization Name:JUNKO K. TAKAGI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-929-8969
Mailing Address - Street 1:PO BOX 110093
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0093
Mailing Address - Country:US
Mailing Address - Phone:907-727-8224
Mailing Address - Fax:907-333-2428
Practice Address - Street 1:1301 E DOWLING RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1436
Practice Address - Country:US
Practice Address - Phone:907-727-8224
Practice Address - Fax:907-333-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK939356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty