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1740309194
ELLAH WALLACE
GARDENA, CA
NPI
1740309194
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA IMF 46459)
Enumeration Date
2007-03-28
Last Update Date
2007-07-08
Business Address
Ms. ELLAH WALLACE MFTI
130 W VICTORIA ST
GARDENA, CA 90248-3523
Phone number: 310-715-2020
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Mailing Address
Ms. ELLAH WALLACE MFTI
4785 DON MIGUEL DR APT 3
LOS ANGELES, CA 90008-4151
Phone number: 323-362-7512
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