JIL DIANE BOTTRELL


Address: 600 University Ave, Fairbanks, AK 99709-3643
Phone: 9074574177

JIL DIANE BOTTRELL (NPI# 1770702524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770702524
Entity Type Individual
Full Name JIL DIANE BOTTRELL
Credential PH.D.
Practice Address 600 University Ave
Fairbanks
AK 99709-3643
Mailing Address 4054 Teal Ave
Fairbanks
AK 99709-3520
Practice Telephone 9074574177
Mailing Telephone 9074794177
Enumeration Date 2007-04-24
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
176 AK Behavioral Health & Social Service Providers

Office Location

Street Address 600 UNIVERSITY AVE
City FAIRBANKS
State AK
Zip Code 99709-3643

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396729174 Michael J. Magowan Marriage & Family Therapist 600 University Ave, Suite 108, Fairbanks, AK 99709-3643 2005-12-05
1811474398 Giles Andrew Hawthorn Counselor 600 University Ave, Fairbanks, AK 99709-3660 2018-07-26
1467979724 Michael D Kolasa Counselor 600 University Ave, Ste 5, Fairbanks, AK 99709 2017-08-28
1932635216 Kristen Erin Schupp Massage Therapist 600 University Ave, Suite 6d, Fairbanks, AK 99709-3660 2017-05-05
1649679564 Kendra Campbell, Phd Psychologist 600 University Ave, Suite 2b, Fairbanks, AK 99709-3651 2014-08-15
1265863427 Alaska Neuropsychological and Behavioral Health, LLC Community/Behavioral Health 600 University Ave, Suite 2 B, Fairbanks, AK 99709-3651 2013-12-12
1679805147 Molly Leahy, Lpc, PC Counselor 600 University Ave, Fairbanks, AK 99701 2010-02-08
1629231568 Wendy Hanford Arundale Psychologist 600 University Ave, Ste. 2, Fairbanks, AK 99709-3660 2008-07-09
1962602243 Roy Glenn Watson Social Worker 600 University Ave, Fairbanks, AK 99709-3643 2007-07-24
1154530103 Elizabeth D Jacobs Speech-Language Pathologist 600 University Ave, Ste. 110, Fairbanks, AK 99709-3643 2007-05-22
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NPI Name Taxonomy Address Enumeration
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1609395409 Shawn K Goggins Counselor 1423 Peger Road, Fairbanks, AK 99709 2017-09-12
1710433347 Jay Titus Technician/Technologist 2884 Marina Drive, Fairbanks, AK 99709 2016-09-01
1710391610 Hannah Summerfelt Dentist 3539 Thomas St, Fairbanks, AK 99709 2014-06-18
1629407325 Diane Louise Mitchell Nurse Practitioner 4650 Harvard Cir, Fairbanks, AK 99709 2013-11-04
1407147929 Christina Martz Counselor 1270 Summet Drive, Fairbanks, AK 99709 2011-05-02
1255652285 Surgery Center of Fairbanks LLC Clinic/Center 2310 Peger Road, Fairbanks, AK 99709 2010-06-14
1962661835 John Leo Hughes Jr Jr. Dentist 3437 Airport Way, Suite 205, Fairbanks, AL 99709 2008-06-05
1508042417 Katherine E Johnson, Md PC Ophthalmology 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 2008-01-10
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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881966414 John Michael Worrall Psychologist 315 5th Ave, Fairbanks, AK 99701-5025 2012-01-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1699940171 Joseph P. Bablonka Psychologist 2735 E Tudor Rd, Anchorage, AK 99507-1135 2008-04-25

Competitor

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City FAIRBANKS
Zip Code 99709

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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