PATRICK WALLACE

SAN DIEGO, CA
NPI1376184408
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-09-30
Last Update Date2019-09-30
Business Address
PATRICK WALLACE
4104 DELTA ST
SAN DIEGO, CA 92113-4113
Phone number: 619-264-0141
Mailing Address
PATRICK WALLACE
4104 DELTA ST
SAN DIEGO, CA 92113-4113
Phone number: