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1871225706
KELLY M WALLACE
EAST LONGMEADOW, MA
NPI
1871225706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-06-29
Last Update Date
2022-06-29
Business Address
KELLY M WALLACE
41 BIRCHLAND AVE
EAST LONGMEADOW, MA 01028-2411
Phone number: 141-388-7495
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Mailing Address
KELLY M WALLACE
41 BIRCHLAND AVE
EAST LONGMEADOW, MA 01028-2411
Phone number: 141-388-7495
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