| NPI | 1093927907 |
|---|---|
| Other Name | GENEVA M. WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 1118L) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 00561-A) |
| 106H00000X Marriage & Family Therapist (Licence: NV R05387) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-07-08 |