Basic Information
| Provider Information | |||||||||
| NPI: | 1881050706 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HONAN | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LPC, MFT-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34 LAVELLE COURT | ||||||||
| Address2: | ILIULIUK FAMILY HEALTH SERVICES | ||||||||
| City: | UNALASKA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996850144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075811202 | ||||||||
| FaxNumber: | 9075812331 | ||||||||
| Practice Location | |||||||||
| Address1: | 34 LAVELLE COURT | ||||||||
| Address2: | ILIULIUK FAMILY HEALTH SERVICES | ||||||||
| City: | UNALASKA | ||||||||
| State: | AK | ||||||||
| PostalCode: | 996850144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075811202 | ||||||||
| FaxNumber: | 9075812331 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2016 | ||||||||
| LastUpdateDate: | 01/07/2016 | ||||||||
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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 | 101YP2500X | 106267 | AK | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.