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1003622937
MADISON WALLACE
DIXON, IL
NPI
1003622937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2024-12-05
Last Update Date
2024-12-05
Business Address
MADISON WALLACE MHP
325 ILLINOIS RT 2
DIXON, IL 61021-9118
Phone number: 815-284-6611
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Mailing Address
MADISON WALLACE MHP
325 ILLINOIS RT 2
DIXON, IL 61021-9118
Phone number: 815-284-6611
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