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1013389113
JENNIFER WALLACE
CUMMING, GA
NPI
1013389113
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC007671)
Enumeration Date
2015-10-28
Last Update Date
2015-10-28
Business Address
-- JENNIFER WALLACE MS, LPC, RPT
110 SAMARITAN DR SUITE 110
CUMMING, GA 30040-2535
Phone number: 888-850-4891
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Mailing Address
-- JENNIFER WALLACE MS, LPC, RPT
110 SAMARITAN DR SUITE 110
CUMMING, GA 30040-2535
Phone number: 888-850-4891
Copy
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