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1679778914
SUSAN K WALLACE
BEND, OR
NPI
1679778914
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2007-06-18
Last Update Date
2007-07-20
Business Address
-- SUSAN K WALLACE
63360 NW BRITTA ST STE 1
BEND, OR 97701-9475
Phone number: 541-318-4845
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Mailing Address
-- SUSAN K WALLACE
21865 BEAR CREEK RD
BEND, OR 97701-9660
Phone number: 541-318-8082
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