JENNIFER WALLACE

SANTA ROSA, CA
NPI1508532953
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  R1441130821)
Enumeration Date2021-08-17
Last Update Date2021-08-26
Business Address
JENNIFER WALLACE RADT
98 HENDLEY ST
SANTA ROSA, CA 95404-5025
Phone number: 707-527-0412
Mailing Address
JENNIFER WALLACE RADT
PO BOX 1356
SANTA ROSA, CA 95402-1356
Phone number: 707-527-0412
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