Individual
NATHANAEL KIRKEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7010 E BOGARD RD, WASILLA, AK 99654-4711
(907) 373-4732
(907) 746-4749
Mailing address
PO BOX 876741, WASILLA, AK 99687-6741
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
03/28/2023
Last updated
04/19/2023
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