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1255975801
ALYCIA GRACE WALLACE
ORANGE, CA
NPI
1255975801
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2019-11-06
Last Update Date
2019-11-06
Business Address
ALYCIA GRACE WALLACE
401 S TUSTIN ST BLDG C
ORANGE, CA 92866-2550
Phone number: 714-361-4860
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Mailing Address
ALYCIA GRACE WALLACE
401 S TUSTIN ST BLDG C
ORANGE, CA 92866-2550
Phone number: 714-361-4860
Copy
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