GENNIFER WALLACE

CHARLESTOWN, IN
NPI1598124992
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2016-02-15
Last Update Date2016-02-15
Business Address
Mrs. GENNIFER WALLACE MA
7509 CHARLESTOWN PIKE
CHARLESTOWN, IN 47111-9623
Phone number: 812-256-4686
Mailing Address
Mrs. GENNIFER WALLACE MA
7509 CHARLESTOWN PIKE
CHARLESTOWN, IN 47111-9623
Phone number: 812-256-4686