Provider Demographics
NPI:1831630797
Name:FUNCTIONAL THERAPY OF ALASKA
Entity type:Organization
Organization Name:FUNCTIONAL THERAPY OF ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:SEATER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:907-360-8513
Mailing Address - Street 1:4041 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5344
Mailing Address - Country:US
Mailing Address - Phone:907-360-8513
Mailing Address - Fax:844-308-8102
Practice Address - Street 1:205 E BENSON BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4019
Practice Address - Country:US
Practice Address - Phone:907-360-8513
Practice Address - Fax:844-308-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKSLPS246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty