Provider Information for 1053694505
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. GUILFORD CLAYBORNE PRICKETTE Jr. LPC
Sex: Male
NPI: 1053694505
Last Updated: 2011-09-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1053694505 | ||||||||
| Enumeration Date | 2011-09-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4320 DIPLOMACY DR SUITE 2121 ANCHORAGE, AK 99508-5925 United States Phone: 907-729-3373 | Fax:907-729-8997 | ||||||||
| Primary Practice Address | 4320 DIPLOMACY DR SUITE 2121 ANCHORAGE, AK 99508-5925 United States Phone: 907-729-3373 | Fax:907-729-8997 | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|