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1043036874
TYLER WALLACE
PORTLAND, ME
NPI
1043036874
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ME MC24119)
Enumeration Date
2024-11-26
Last Update Date
2024-11-26
Business Address
TYLER WALLACE LMSW-CC
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103-2842
Phone number: 207-871-1200
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Mailing Address
TYLER WALLACE LMSW-CC
901 WASHINGTON AVE STE 100
PORTLAND, ME 04103-2842
Phone number: 207-871-1200
Copy
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