GORDON STEVEN WALLACE

BILLINGS, MT
NPI1902902059
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: MT  970)
Additional Taxonomies101YP2500X Counselor Professional
(Licence: MT  942-LCPC)
Enumeration Date2006-09-16
Last Update Date2007-07-08
Business Address
MR. GORDON STEVEN WALLACE L.C.P.C. / L.A.C.
1250 15TH ST W
BILLINGS, MT 59102-4155
Phone number: 406-256-1434
Mailing Address
MR. GORDON STEVEN WALLACE L.C.P.C. / L.A.C.
1250 15TH ST W P.O. BOX 50090
BILLINGS, MT 59102-4155
Phone number: 406-256-1434
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