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1003116658
MICHAEL EUGENE WALLACE
ANN ARBOR, MI
NPI
1003116658
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MI 6301008847)
Enumeration Date
2010-10-29
Last Update Date
2010-10-29
Business Address
Mr. MICHAEL EUGENE WALLACE MA
201 E LIBERTY ST SUITE 2
ANN ARBOR, MI 48104-2118
Phone number: 734-330-3580
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Mailing Address
Mr. MICHAEL EUGENE WALLACE MA
201 E. LIBERTY ST. SUITE 2
ANN ARBOR, MI 48104
Phone number: 734-330-3580
Copy
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