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1447740238
CORY ALEXIS WALLACE
TIGARD, OR
NPI
1447740238
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-05-16
Last Update Date
2021-03-30
Business Address
CORY ALEXIS WALLACE
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3690
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Mailing Address
CORY ALEXIS WALLACE
8915 SW CENTER ST
TIGARD, OR 97223-6307
Phone number: 503-726-3690
Copy
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