Basic Information
| Provider Information | |||||||||
| NPI: | 1477699247 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARGEANT | ||||||||
| FirstName: | DESTINY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34881 | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998034881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074633087 | ||||||||
| FaxNumber: | 9073644487 | ||||||||
| Practice Location | |||||||||
| Address1: | 9000 GLACIER HWY | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998018032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077239828 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 11/07/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 348 | AK | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.