JERRON WALLACE

ALBUQUERQUE, NM
NPI1033589247
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM  X-09336)
Enumeration Date2015-09-30
Last Update Date2017-01-19
Business Address
-- JERRON WALLACE LMSW
912 1ST ST NW
ALBUQUERQUE, NM 87102-2355
Phone number: 505-224-9777
Mailing Address
-- JERRON WALLACE LMSW
912 1ST ST NW
ALBUQUERQUE, NM 87102-2355
Phone number: 505-224-9777
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