MICHAEL DAVID WALLACE

MILWAUKEE, WI
NPI1477610285
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: WI  2578-123)
Enumeration Date2007-01-02
Last Update Date2007-07-08
Business Address
-- MICHAEL DAVID WALLACE LCSW
10850 W PARK PL SUITE # 100
MILWAUKEE, WI 53224-3606
Phone number: 262-542-3255
Mailing Address
-- MICHAEL DAVID WALLACE LCSW
3022 N 81ST ST
MILWAUKEE, WI 53222-4810
Phone number: 414-449-1491
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