EVAN BARRINGTON WALLACE

SAN DIEGO, CA
NPI1497226229
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1321750918)
Enumeration Date2018-12-05
Last Update Date2018-12-05
Business Address
EVAN BARRINGTON WALLACE RADT
2980 CEDAR ST
SAN DIEGO, CA 92102-1515
Phone number: 619-260-7370
Mailing Address
EVAN BARRINGTON WALLACE RADT
2980 CEDAR ST
SAN DIEGO, CA 92102-1515
Phone number: 619-260-1605