STACY LEA WALLACE

PAWNEE, OK
NPI1003249848
Former NameSTACY WALLACE MARTIN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2013-08-15
Last Update Date2013-08-15
Business Address
-- STACY LEA WALLACE NCC
540 ILLINOIS ST
PAWNEE, OK 74058-2036
Phone number: 918-762-1045
Mailing Address
-- STACY LEA WALLACE NCC
540 ILLINOIS ST
PAWNEE, OK 74058-2036
Phone number: 918-762-1045
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