DEANA L WALLACE

BAKER CITY, OR
NPI1912423229
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-21-883)
Enumeration Date2017-08-17
Last Update Date2021-07-29
Business Address
DEANA L WALLACE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
Mailing Address
DEANA L WALLACE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400