Most Relevant Information
Provider Data
| NPI Number: | 1003546631 |
| Provider Name: | SAGE KENSLEY DEMALLIE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/15/2022 |
| Last Updated: | 06/15/2022 |
Provider Practice Location
4160 TUDOR CENTRE DR
ANCHORAGE
AK
995085901
Practice Location Phone/Fax
| Phone: | 9077298694 |
| Fax: | 9077296366 |
Provider Mailing Location
4160 TUDOR CENTRE DR
ANCHORAGE
AK
995085901
Provider Mailing Phone/Fax
| Phone: | 9077298694 |
| Fax: | 9077296366 |