KANISHIA WALLACE

DEERFIELD BEACH, FL
NPI1023413515
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2014-10-27
Last Update Date2019-05-03
Business Address
KANISHIA WALLACE
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441-1817
Phone number: 888-880-9270
Mailing Address
KANISHIA WALLACE
500 FAIRWAY DR STE 102
DEERFIELD BEACH, FL 33441-1817
Phone number: 888-880-9270
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