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1750988127
STEPHANIE WALLACE
CHULA VISTA, CA
NPI
1750988127
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 121620)
Enumeration Date
2020-10-07
Last Update Date
2020-10-07
Business Address
STEPHANIE WALLACE Associate MFT
730 MEDICAL CENTER CT
CHULA VISTA, CA 91911-6618
Phone number: 619-980-0237
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Mailing Address
STEPHANIE WALLACE Associate MFT
935 RANGEVIEW ST
SPRING VALLEY, CA 91977-4759
Phone number: 303-590-8221
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