Healthcare Provider Details

I. General information

NPI: 1003743121
Provider Name (Legal Business Name): HANNAH RACHELLE KEMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDER HAYDEN KEMP

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 HUFFMAN RD STE 24-580
ANCHORAGE AK
99515-3516
US

IV. Provider business mailing address

1120 HUFFMAN RD STE 24-580 STE 24-580
ANCHORAGE AK
99515-3516
US

V. Phone/Fax

Practice location:
  • Phone: 907-306-3810
  • Fax:
Mailing address:
  • Phone: 907-306-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: