Doctor Name: | LYNDA J PLETTNER |
NPI Number: | 1154503688 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RL7898 |
Business Practice Address: | 12528 Hawk Lane Houston, AK - 996942528 |
Business Phone Number: | 9078926944 |
Business Fax Number: | 9078926945 |
Mailing Address: | Po Box 299136, WASILLA |
State: | AK |
Postal Code: | 996299136 |
Phone Number: | 9078926944 |
Fax Number: | 9078926945 |
NPI Enumeration Date: | 11/27/2007 |
NPI Last Update Date: | 04/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | RL7898 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |