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1538575873
BREANNA WALLACE
FOREST HILLS, NY
NPI
1538575873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: NY 025278)
Enumeration Date
2014-07-08
Last Update Date
2016-12-12
Business Address
-- BREANNA WALLACE
9130 METROPOLITAN AVE
FOREST HILLS, NY 11375-6671
Phone number: 718-286-4700
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Mailing Address
-- BREANNA WALLACE
9130 METROPOLITAN AVE
FOREST HILLS, NY 11375-6671
Phone number: 718-286-4700
Copy
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