Individual provider · Type 1 NPI
Tanner Wade Kettwig
Mental Health Counselor · Wasilla, AK
NPI number
1063395325
Active
Practice location
4040 S Discovery Bay Dr
Wasilla, AK 99654-0397
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1063395325
Tanner Wade Kettwig's National Provider Identifier is 1063395325, issued on Jul 25, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Wasilla, AK. The record was last updated on Jul 25, 2025.