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1356501241
MICHELLE WALLACE
LONG BEACH, CA
NPI
1356501241
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2008-06-13
Last Update Date
2008-06-13
Business Address
-- MICHELLE WALLACE
100 E MARKET ST
LONG BEACH, CA 90805-5924
Phone number: 562-428-4222
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Mailing Address
-- MICHELLE WALLACE
26460 SUMMIT CIR
SANTA CLARITA, CA 91350-2991
Phone number:
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