Healthcare Provider Details

I. General information

NPI: 1043454259
Provider Name (Legal Business Name): RACHEL E BARRY-THOMASON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 05/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W INTERNATIONAL AIRPORT RD
ANCHORAGE AK
99518-1105
US

IV. Provider business mailing address

540 W INTERNATIONAL AIRPORT RD
ANCHORAGE AK
99518-1105
US

V. Phone/Fax

Practice location:
  • Phone: 907-561-5335
  • Fax: 907-564-7429
Mailing address:
  • Phone: 907-561-5335
  • Fax: 907-564-7429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number383
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: