WALTER (RUSTY) WALLACE OTTO

SACRAMENTO, CA
NPI1649682469
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: CA  PSY12396)
Enumeration Date2014-05-28
Last Update Date2014-05-28
Business Address
-- WALTER (RUSTY) WALLACE OTTO PHD
1970 UNIVERSITY PARK DRIVE
SACRAMENTO, CA 95825
Phone number: 916-804-5087
Mailing Address
-- WALTER (RUSTY) WALLACE OTTO PHD
1970 UNIVERSITY PARK DRIVE
SACRAMENTO, CA 95825
Phone number: 916-804-5087