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1043958176
SUSAN R WALLACE
CHICAGO, IL
NPI
1043958176
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-05-27
Last Update Date
2022-05-27
Business Address
SUSAN R WALLACE
2715 N CENTRAL AVE
CHICAGO, IL 60639-1351
Phone number: 773-360-1389
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Mailing Address
SUSAN R WALLACE
86 E 13TH ST
CHICAGO HEIGHTS, IL 60411-2761
Phone number: 708-466-9457
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