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1124675749
KELLY LOVE WALLACE
EDMOND, OK
NPI
1124675749
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 77947)
Enumeration Date
2019-08-19
Last Update Date
2021-08-27
Business Address
KELLY LOVE WALLACE M. Ed.
2817 STONEBROOK RD
EDMOND, OK 73003-2105
Phone number: 214-600-3503
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Mailing Address
KELLY LOVE WALLACE M. Ed.
2817 STONEBROOK RD
EDMOND, OK 73003-2105
Phone number: 214-600-3503
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