KEYONNA WALLACE

KEW GARDENS, NY
NPI1861032864
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  31387)
Enumeration Date2020-01-08
Last Update Date2020-10-19
Business Address
KEYONNA WALLACE
8002 KEW GARDENS RD STE 704
KEW GARDENS, NY 11415-3607
Phone number: 718-520-1513
Mailing Address
KEYONNA WALLACE
79 GLENRIDGE RD
GLENVILLE, NY 12302-4523
Phone number:
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