Healthcare Provider Details

I. General information

NPI: 1457215295
Provider Name (Legal Business Name): NAVY BLU TOGIOLA-TAIMI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 DEBARR
ANCHORAGE AK
99508-3103
US

IV. Provider business mailing address

8101 MEDELLIN CIR
ANCHORAGE AK
99507-3270
US

V. Phone/Fax

Practice location:
  • Phone: 907-222-7300
  • Fax:
Mailing address:
  • Phone: 907-787-9579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: