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ANTHONY GASTELUM

>> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1497125637

Individual Registrant:
 ANTHONY  GASTELUM 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
101 TOTEM ST. KAKE CLINIC KAKE, AK 99830 US
Tel: 907-785-6515  Fax: 907-785-3350

Contact information for business:
PO BOX 589  KAKE, AK 99830-0589 US
Tel: 907-785-6515  Fax: 907-785-3350

Registration Information:
NPI: 1497125637
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor
AK101YA0400X
N101Y00000XBehavioral Health & Social Service Providers
Counselor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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