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1053748038
TRACEY WALLACE
ATLANTA, GA
NPI
1053748038
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-10-04
Last Update Date
2013-10-04
Business Address
Mrs. TRACEY WALLACE
122 WOLF TAIL CT SW
ATLANTA, GA 30349-6547
Phone number: 336-210-2957
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Mailing Address
Mrs. TRACEY WALLACE
122 WOLF TAIL CT SW
ATLANTA, GA 30349-6547
Phone number: 336-210-2957
Copy
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