AMANDA WALLACE

ST CHARLES, IL
NPI1053725952
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IL  242.003032)
Enumeration Date2014-06-18
Last Update Date2014-06-18
Business Address
-- AMANDA WALLACE
40W310 LAFOX RD SUITE A1/B1
ST CHARLES, IL 60175-6588
Phone number: 630-444-0077
Mailing Address
-- AMANDA WALLACE
12 HARRISON ST APT 3
OAK PARK, IL 60304-1771
Phone number:
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