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1003117284
MELANY A WALLACE
LONG BEACH, CA
NPI
1003117284
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA RI-W1009040752)
Enumeration Date
2010-11-04
Last Update Date
2010-11-04
Business Address
Ms. MELANY A WALLACE
1601 E 10TH ST
LONG BEACH, CA 90813-5035
Phone number: 562-218-3639
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Mailing Address
Ms. MELANY A WALLACE
1601 E 10TH ST
LONG BEACH, CA 90813-5035
Phone number: 562-218-3639
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