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1215549555
KIRSTEN N WALLACE
COVINGTON, LA
NPI
1215549555
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-08-18
Last Update Date
2020-08-18
Business Address
KIRSTEN N WALLACE N/A
1505 N FLORIDA ST
COVINGTON, LA 70433-1544
Phone number: 985-781-6080
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Mailing Address
KIRSTEN N WALLACE N/A
1505 N FLORIDA ST
COVINGTON, LA 70433-1544
Phone number:
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