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1821163023
VIVIAN DYANNE WALLACE
LAWRENCEVILLE, GA
NPI
1821163023
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: GA SLP000631)
Enumeration Date
2006-11-22
Last Update Date
2007-07-08
Business Address
Ms. VIVIAN DYANNE WALLACE M.Ed.
735 LONGLEAF BLVD SUITE A
LAWRENCEVILLE, GA 30045-8460
Phone number: 770-995-2378
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Mailing Address
Ms. VIVIAN DYANNE WALLACE M.Ed.
735 LONGLEAF BLVD SUITE A
LAWRENCEVILLE, GA 30045-8460
Phone number: 770-995-2378
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