Forrest Blake Kostek
Forrest Blake Kostek is a Mental Health Counselor in Wasilla, Alaska. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
291 E Swanson AveWasilla, AK 99654-7004
Phone: (907) 715-9423
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1104425172 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | October 21, 2020 |
| Last updated in NPPES | October 21, 2020 |
| Certification date | October 21, 2020 |
| Mailing address | 291 E Swanson Ave, Wasilla, AK 99654-7004 |
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