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1215407945
CHAUNCEY WALLACE
MARION, OH
NPI
1215407945
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 050034)
Enumeration Date
2018-11-26
Last Update Date
2018-11-26
Business Address
CHAUNCEY WALLACE CDCA
284 S STATE ST
MARION, OH 43302-3940
Phone number: 614-832-7647
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Mailing Address
CHAUNCEY WALLACE CDCA
284 S STATE ST
MARION, OH 43302-3940
Phone number: 614-832-7647
Copy
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