Individual
DYLAN MICHAEL DESANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
51310 TIMBER BAY CT, HOMER, AK 99603
(907) 235-3250
(907) 235-3251
Mailing address
PO BOX 876741, WASILLA, AK 99687-6741
(907) 373-4732
(907) 746-4749
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
03/03/2021
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