| NPI | 1427199157 |
|---|---|
| Other Name | PATRICIA FAYE WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY 16726) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 16726) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2015-09-01 |