BENNETT ALLAN WALLACE

LOUISVILLE, KY
NPI1699042788
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: KY  3772)
Enumeration Date2011-11-17
Last Update Date2011-11-17
Business Address
Mr. BENNETT ALLAN WALLACE M.S.S.W
164 E ASHLAND AVE
LOUISVILLE, KY 40214-1908
Phone number: 502-693-2606
Mailing Address
Mr. BENNETT ALLAN WALLACE M.S.S.W
164 E ASHLAND AVE
LOUISVILLE, KY 40214-1908
Phone number: 502-693-2606
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