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1508185307
KATHLEEN MICHELLE WALLACE
RUSSELLVILLE, AR
NPI
1508185307
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AR P1507083)
Enumeration Date
2010-05-19
Last Update Date
2016-02-15
Business Address
-- KATHLEEN MICHELLE WALLACE LPC, NCC
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
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Mailing Address
-- KATHLEEN MICHELLE WALLACE LPC, NCC
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-967-5570
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