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1588142434
MADISON JULIA WALLACE
CAMARILLO, CA
NPI
1588142434
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-08-02
Last Update Date
2018-08-02
Business Address
MADISON JULIA WALLACE
5284 ADOLFO RD STE 100
CAMARILLO, CA 93012-6790
Phone number: 805-289-0120
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Mailing Address
MADISON JULIA WALLACE
5284 ADOLFO RD STE 100
CAMARILLO, CA 93012-6790
Phone number: 805-289-0120
Copy
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