LISA A WALLACE

DURANT, OK
NPI1609155571
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2011-08-10
Last Update Date2011-08-10
Business Address
-- LISA A WALLACE
1604 N WASHINGTON AVE
DURANT, OK 74701-2128
Phone number: 580-920-0909
Mailing Address
-- LISA A WALLACE
1604 N WASHINGTON AVE
DURANT, OK 74701-2128
Phone number: 580-920-0909
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