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1053501783
ROGER A WALLACE
ARDEN, NC
NPI
1053501783
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: NC 1179)
Enumeration Date
2007-07-30
Last Update Date
2008-10-16
Business Address
-- ROGER A WALLACE MA
410 MILLS GAP RD.
ARDEN, NC 28704
Phone number: 828-654-0111
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Mailing Address
-- ROGER A WALLACE MA
PO BOX 127
ARDEN, NC 28704-0127
Phone number: 828-654-0111
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