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1366635245
AMANDA WALLACE
LONGMONT, CO
NPI
1366635245
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: CO 3502)
Enumeration Date
2007-08-23
Last Update Date
2007-08-23
Business Address
MS. AMANDA WALLACE MA, LPC
1907 KRISTY CT
LONGMONT, CO 80504-7387
Phone number: 303-507-5210
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Mailing Address
MS. AMANDA WALLACE MA, LPC
1907 KRISTY CT
LONGMONT, CO 80504-7387
Phone number: 303-507-5210
Copy
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