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1417452731
ANGELA KATHLEEN WALLACE
LOS ANGELES, CA
NPI
1417452731
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 45450)
Enumeration Date
2018-03-28
Last Update Date
2018-03-28
Business Address
ANGELA KATHLEEN WALLACE MFT #45450
554 S SAN VICENTE BLVD STE 200
LOS ANGELES, CA 90048-4651
Phone number: 310-862-4668
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Mailing Address
ANGELA KATHLEEN WALLACE MFT #45450
554 S SAN VICENTE BLVD STE 200
LOS ANGELES, CA 90048-4651
Phone number: 310-862-4668
Copy
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