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General NPI Number Information
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NPI Number | 1356478366
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Entity Type | Individual
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Provider Name | DIANE LOUISE GILBREATH LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 UNIVERSITY AVE STE 2
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City | FBKS
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State | AK
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Zip | 99709
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Country | US
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Telephone | 907-374-4410
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Fax | 907-374-9801
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Provider Business Mailing Address
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Address Line | PO BOX 10048
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City | FBKS
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State | AK
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Zip | 99710
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Country | US
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Telephone | 907-457-3363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AA91
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License Number State | AK
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