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1467819276
AMANDA WALLACE
MELBOURNE, FL
NPI
1467819276
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-01-25
Last Update Date
2023-03-10
Business Address
AMANDA WALLACE
4450 W EAU GALLIE BLVD SUITE 200
MELBOURNE, FL 32934-7213
Phone number: 321-726-2860
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Mailing Address
AMANDA WALLACE
400 E SHERIDAN RD
MELBOURNE, FL 32901-3184
Phone number: 321-722-5200
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