WALLACE STACY

WILTON, CT
NPI1588190862
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CT  007936)
Enumeration Date2017-05-05
Last Update Date2017-05-05
Business Address
Mr. WALLACE STACY LCSW
21 RICHDALE DR APT A
WILTON, CT 06897-2008
Phone number: 914-309-6442
Mailing Address
Mr. WALLACE STACY LCSW
21 RICHDALE DR APT A
WILTON, CT 06897-2008
Phone number: 914-309-6442
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