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General NPI Number Information
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NPI Number | 1942364112
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Entity Type | Individual
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Provider Name | DAVID B BATES LPC
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 122 10TH AVENUE
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City | FAIRBANKS
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State | AK
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Zip | 99701
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Country | US
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Telephone | 907-457-6002
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Fax | 907-457-3610
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Provider Business Mailing Address
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Address Line | PO BOX 10337
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City | FAIRBANKS
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State | AK
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Zip | 99710-0337
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Country | US
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Telephone | 907-457-6002
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 408
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License Number State | AK
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