Doctor Name: | KRISTINA LYNN SKOOG |
NPI Number: | 1174831721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LPC |
License Number: | 915 |
Business Practice Address: | Mile 58 Old Glenn Hwy Palmer, AK - 99645 |
Business Phone Number: | 9077455054 |
Business Fax Number: | |
Mailing Address: | Po Box 919, PALMER |
State: | AK |
Postal Code: | 996450919 |
Phone Number: | 9077455054 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2010 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |