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1861883159
MADONNA WALLACE
BATESVILLE, AR
NPI
1861883159
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AR A 1501018)
Enumeration Date
2015-02-09
Last Update Date
2015-02-09
Business Address
-- MADONNA WALLACE
25 GAP RD
BATESVILLE, AR 72501-8679
Phone number: 870-793-8900
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Mailing Address
-- MADONNA WALLACE
25 GAP ROAD
BATESVILLE, AR 72501-2578
Phone number: 870-793-8900
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