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1447553300
PATRICIA A WALLACE
CAMARILLO, CA
NPI
1447553300
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 040970)
Enumeration Date
2010-12-15
Last Update Date
2010-12-15
Business Address
-- PATRICIA A WALLACE CATC
450 ROSEWOOD AVE SUITE215
CAMARILLO, CA 93010-5914
Phone number: 805-482-1265
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Mailing Address
-- PATRICIA A WALLACE CATC
450 ROSEWOOD AVE SUITE215
CAMARILLO, CA 93010-5914
Phone number: 805-482-1265
Copy
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