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1053803312
LIONEL WALLACE
YPSILANTI, MI
NPI
1053803312
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MI 7101002558)
Enumeration Date
2018-06-03
Last Update Date
2018-06-03
Business Address
LIONEL WALLACE
5577 WHITTAKER RD
YPSILANTI, MI 48197-9752
Phone number: 734-395-9282
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Mailing Address
LIONEL WALLACE
1887 SAVANNAH LN
YPSILANTI, MI 48198-3678
Phone number: 734-395-9282
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