STACEY WALLACE

KENOSHA, WI
NPI1053136317
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: WI  251425-30)
Enumeration Date2024-11-20
Last Update Date2024-11-20
Business Address
STACEY WALLACE RN
3825 39TH AVE STE 120
KENOSHA, WI 53144-2043
Phone number: 262-946-5752
Mailing Address
STACEY WALLACE RN
3825 39TH AVE STE 120
KENOSHA, WI 53144-2043
Phone number: 262-946-5752
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