ANDREW ANTHONY WALLACE

COLTON, CA
NPI1174856587
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  RS9874)
Enumeration Date2009-09-16
Last Update Date2009-09-16
Business Address
Mr. ANDREW ANTHONY WALLACE
1076 SANTO ANTONIO DR SUITE B
COLTON, CA 92324-8103
Phone number: 909-433-9824
Mailing Address
Mr. ANDREW ANTHONY WALLACE
1076 SANTO ANTONIO DR SUITE B
COLTON, CA 92324-8103
Phone number: 909-433-9824