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1386524262
DIANNA LYNN WALLACE
WASILLA, AK
NPI
1386524262
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2025-09-03
Last Update Date
2025-09-03
Business Address
-- DIANNA LYNN WALLACE
7010 E BOGARD RD
WASILLA, AK 99654-4711
Phone number: 907-373-4732
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Mailing Address
-- DIANNA LYNN WALLACE
PO BOX 876741
WASILLA, AK 99687-6741
Phone number: 907-373-4732
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