Individual
TANNER WADE KETTWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4040 S DISCOVERY BAY DR, WASILLA, AK 99654-0397
(605) 467-9129
Mailing address
4040 S DISCOVERY BAY DR, WASILLA, AK 99654-0397
(605) 467-9129
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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