MIKE THOMAS WALLACE

GLENDALE, AZ
NPI1043446420
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: AZ  10676)
Enumeration Date2009-05-30
Last Update Date2009-05-30
Business Address
MR. MIKE THOMAS WALLACE L.P.C.
7075 W BELL RD
GLENDALE, AZ 85308-8546
Phone number: 623-810-4959
Mailing Address
MR. MIKE THOMAS WALLACE L.P.C.
7075 W BELL RD
GLENDALE, AZ 85308-8546
Phone number: 623-810-4959
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