LISA M WALLACE

FORT COLLINS, CO
NPI1124002571
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: CO  5913)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: WY  906)
Enumeration Date2005-11-30
Last Update Date2021-03-15
Business Address
LISA M WALLACE MA, LPC
4103 E BOARDWALK DRIVE SUITE 202
FORT COLLINS, CO 80525-5930
Phone number: 970-817-4049
Mailing Address
LISA M WALLACE MA, LPC
PO BOX 273338
FORT COLLINS, CO 80527-3338
Phone number: 970-817-4049