Individual
JODY DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CDC I
Contact information
Practice address
300 N MAIN ST, WASILLA, AK 99654-7017
(907) 357-8784
Mailing address
300 N MAIN ST, WASILLA, AK 99654-7017
(907) 357-8784
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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