Dianna Lynn Wallace

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Wasilla, AK

NPI 1386524262 · NPPES record last updated Sep 3, 2025

Key facts

NPI
1386524262
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
7010 E Bogard Rd
Wasilla, AK 99654-4711
Phone
(907) 373-4732
NPI assigned
Sep 3, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X AK Yes

Addresses

Primary practice location

7010 E Bogard Rd
Wasilla, AK 99654-4711

Mailing address

PO Box 876741
Wasilla, AK 99687-6741
Phone (907) 373-4732

Other providers in Wasilla, AK

All providers in Wasilla, AK · Addiction (Substance Use Disorder) Counselor in Alaska

Sources for this page

Verify at the official NPI Registry.