Basic Information
| Provider Information | |||||||||
| NPI: | 1851447973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOVCASKI | ||||||||
| FirstName: | LIGIA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1135 WILLIAMS ROAD | ||||||||
| Address2: | |||||||||
| City: | NORTH POLE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074740890 | ||||||||
| FaxNumber: | 9074743621 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 5TH AVENUE | ||||||||
| Address2: | |||||||||
| City: | FAIRBANKS | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074740890 | ||||||||
| FaxNumber: | 9074743621 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 458 | AK | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.