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1720532526
EBONY WALLACE
CULVER CITY, CA
NPI
1720532526
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 747356)
Enumeration Date
2016-08-09
Last Update Date
2016-08-09
Business Address
-- EBONY WALLACE
9808 VENICE BLVD
CULVER CITY, CA 90232-2732
Phone number: 310-945-3350
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Mailing Address
-- EBONY WALLACE
9808 VENICE BLVD
CULVER CITY, CA 90232-2732
Phone number: 310-945-3350
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