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1639811136
MATTHEW WALLACE
FOLSOM, CA
NPI
1639811136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103T00000X Psychologist
(Licence: CA 33214)
Enumeration Date
2022-04-13
Last Update Date
2022-04-13
Business Address
MATTHEW WALLACE
525 WILLARD DR APT 1634
FOLSOM, CA 95630-4073
Phone number: 818-661-7882
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Mailing Address
MATTHEW WALLACE
525 WILLARD DR APT 1634
FOLSOM, CA 95630-4073
Phone number: 818-661-7882
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