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1003064213
JENNIFER WALLACE
GREELEY, CO
NPI
1003064213
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CO CSW.00001141)
Enumeration Date
2008-08-29
Last Update Date
2014-09-09
Business Address
-- JENNIFER WALLACE LCSW
1300 N 17TH AVE
GREELEY, CO 80631-9584
Phone number: 970-347-2120
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Mailing Address
-- JENNIFER WALLACE LCSW
1300 N 17TH AVE
GREELEY, CO 80631-9584
Phone number: 970-347-2120
Copy
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