Individual provider · Type 1 NPI

Jerry Dwyane Shough

Mental Health Counselor · Anchorage, AK

NPI number 1295341428 Active

Practice location

1709 Bragaw St
Anchorage, AK 99508-3436

Call (907) 562-5340 Map

Mailing address

2720 Derby Way
Anchorage, AK 99504-3231

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1295341428

Jerry Dwyane Shough's National Provider Identifier is 1295341428, issued on Sep 22, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Anchorage, AK. The record was last updated on Sep 22, 2020.