Individual provider · Type 1 NPI

Forrest Blake Kostek

Mental Health Counselor · Wasilla, AK

NPI number 1104425172 Active

Practice location

291 E Swanson Ave
Wasilla, AK 99654-7004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104425172

Forrest Blake Kostek's National Provider Identifier is 1104425172, issued on Oct 21, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Wasilla, AK. The record was last updated on Oct 21, 2020.