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1649682469
WALTER (RUSTY) WALLACE OTTO
SACRAMENTO, CA
NPI
1649682469
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: CA PSY12396)
Enumeration Date
2014-05-28
Last Update Date
2014-05-28
Business Address
-- WALTER (RUSTY) WALLACE OTTO PHD
1970 UNIVERSITY PARK DRIVE
SACRAMENTO, CA 95825
Phone number: 916-804-5087
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Mailing Address
-- WALTER (RUSTY) WALLACE OTTO PHD
1970 UNIVERSITY PARK DRIVE
SACRAMENTO, CA 95825
Phone number: 916-804-5087
Copy
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