BRIAN WALLACE

UPLAND, CA
NPI1437879418
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-08-31
Last Update Date2022-08-31
Business Address
BRIAN WALLACE
239 W 9TH ST
UPLAND, CA 91786-5979
Phone number: 909-920-5102
Mailing Address
BRIAN WALLACE
762 NORTH RD
SAN BERNARDINO, CA 92404-2439
Phone number: 714-595-5314
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