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NPI Code Detail

MEDICARE: LELINDA ANNE BOURGEOIS II

MEDICARE:   LELINDA ANNE BOURGEOIS II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1801918800
Entity Type Code : Individual
Provider Name (Legal Business Name) : LELINDA ANNE BOURGEOIS II
Provider Business Mailing Address
First Line : 4045 LAKE OTIS PKWY STE 101
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5227
Country : US
Telephone Number : 907-762-2815
Fax Number :
Provider Business Practice Location Address
First Line : 4045 LAKE OTIS PKWY STE 101
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5227
Country : US
Telephone Number : 907-762-2815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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Directions to “ LELINDA ANNE BOURGEOIS II ” Practice Location

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