Kennon Grigg
Individual provider Active NPI Counselor · Juneau, AK
NPI 1932300985 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1932300985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 3406 Glacier Hwy
Juneau, AK 99801-9501 - Phone
- (907) 463-3303
- Fax
- (907) 463-6858
- NPI assigned
- May 29, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
3406 Glacier Hwy
Juneau, AK 99801-9501
Mailing address
3406 Glacier Hwy
Juneau, AK 99801-9501
Phone (907) 463-3303
Other providers in Juneau, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.