Doctor Name: | CAROLYN PAKUTZ |
NPI Number: | 1003136219 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 3830 S Cushman St Fairbanks, AK - 997017530 |
Business Phone Number: | 9074521575 |
Business Fax Number: | |
Mailing Address: | 3830 S Cushman St, FAIRBANKS |
State: | AK |
Postal Code: | 997017530 |
Phone Number: | 9074521575 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2010 |
NPI Last Update Date: | 06/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |