THERESA WALLIS

SHAWNEE, OK
NPI1639509862
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TR0400X Psychologist, Rehabilitation
Enumeration Date2013-11-25
Last Update Date2013-11-25
Business Address
-- THERESA WALLIS
201 N BROADWAY AVE
SHAWNEE, OK 74801-6917
Phone number: 580-748-0342
Mailing Address
-- THERESA WALLIS
10800 EASTWAY
MCLOUD, OK 74851-8566
Phone number: 580-748-0342
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