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1710264940
CYNTHIA L WALLACE
STATEN ISLAND, NY
NPI
1710264940
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2011-11-16
Last Update Date
2011-11-16
Business Address
Miss CYNTHIA L WALLACE Therapist
358 SAINT MARKS PL
STATEN ISLAND, NY 10301-2417
Phone number: 718-727-3303
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Mailing Address
Miss CYNTHIA L WALLACE Therapist
51 TREMONT TER
IRVINGTON, NJ 07111-3709
Phone number:
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