| Ballaine Psychological Services Inc | |
|
1040 Meadow Mouse Rd Fairbanks AK 99709-6618 | |
| (907) 479-8933 | |
| (907) 479-8934 |
| Full Name | Ballaine Psychological Services Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1040 Meadow Mouse Rd, Fairbanks, Alaska |
| Authorized Official Name and Position | Kornelia Grabinska (PRESIDENT) |
| Authorized Official Contact | 9074798933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ballaine Psychological Services Inc 1040 Meadow Mouse Rd Fairbanks AK 99709-6618 Ph: (907) 479-8933 | Ballaine Psychological Services Inc 1040 Meadow Mouse Rd Fairbanks AK 99709-6618 Ph: (907) 479-8933 |
| NPI Number | 1841287885 |
|---|---|
| Provider Enumeration Date | 10/04/2005 |
| Last Update Date | 12/28/2020 |
| Certification Date | 12/28/2020 |
| Medicare PECOS PAC ID | 2961492129 |
|---|---|
| Medicare Enrollment ID | O20040518000695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841287885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kornelia Grabinska |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124015169 PECOS PAC ID: 1355331521 Enrollment ID: I20040519000536 |
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