ROBERT E WALLACE

COOS BAY, OR
NPI1679455703
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OR  25-QMHP-R-3536)
Enumeration Date2025-07-21
Last Update Date2025-07-21
Business Address
ROBERT E WALLACE
93463 ALABAMA LN
COOS BAY, OR 97420-3977
Phone number: 660-525-6182
Mailing Address
ROBERT E WALLACE
PO BOX 653
COOS BAY, OR 97420-0124
Phone number:
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