CHANTEL LEE WALLACE

BLACKFOOT, ID
NPI1669234308
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LMSW-43731)
Enumeration Date2024-01-29
Last Update Date2024-01-29
Business Address
CHANTEL LEE WALLACE
581 N ASH ST
BLACKFOOT, ID 83221-2223
Phone number: 208-973-5077
Mailing Address
CHANTEL LEE WALLACE
581 N ASH ST
BLACKFOOT, ID 83221-2223
Phone number: 208-973-5077
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