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1750766937
JANNA WALLACE
PLACERVILLE, CA
NPI
1750766937
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-07-29
Last Update Date
2015-07-29
Business Address
-- JANNA WALLACE RADTI
6387 MOTHER LODE DR SPC 78
PLACERVILLE, CA 95667-8225
Phone number: 530-409-4310
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Mailing Address
-- JANNA WALLACE RADTI
6387 MOTHER LODE DR SPC 78
PLACERVILLE, CA 95667-8225
Phone number: 530-409-4310
Copy
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