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General NPI Number Information
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NPI Number | 1972727725
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Entity Type | Individual
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Provider Name | KATHRYN LOIS CARSSOW MS, LPA
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3050 5TH AVE
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City | KETCHIKAN
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State | AK
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Zip | 99901-5773
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Country | US
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Telephone | 907-228-6521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9078
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City | KETCHIKAN
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State | AK
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Zip | 99901-4078
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Country | US
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Telephone | 907-247-7909
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 535
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License Number State | AK
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