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1225625684
DYLAN MICHAEL DESANNO
HOMER, AK
NPI
1225625684
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-12-30
Last Update Date
2021-03-03
Business Address
DYLAN MICHAEL DESANNO
51310 TIMBER BAY CT
HOMER, AK 99603
Phone number: 907-235-3250
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Mailing Address
DYLAN MICHAEL DESANNO
PO BOX 876741
WASILLA, AK 99687-6741
Phone number: 907-373-4732
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