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1922446103
SIMONA WALLACE
BENTON, AR
NPI
1922446103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-06-10
Last Update Date
2013-06-12
Business Address
-- SIMONA WALLACE Recovery Assistant
1502 MARY KAY BLVD
BENTON, AR 72015-8909
Phone number: 501-315-3344
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Mailing Address
-- SIMONA WALLACE Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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