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1912423229
DEANA L WALLACE
BAKER CITY, OR
NPI
1912423229
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-21-883)
Enumeration Date
2017-08-17
Last Update Date
2021-07-29
Business Address
DEANA L WALLACE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
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Mailing Address
DEANA L WALLACE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
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