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1932855871
JESSICA M WALLACE
VIROQUA, WI
NPI
1932855871
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WI 5593125)
Enumeration Date
2022-03-01
Last Update Date
2022-03-05
Business Address
JESSICA M WALLACE LPC
414 S EAST AVE
VIROQUA, WI 54665-2006
Phone number: 608-638-3332
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Mailing Address
JESSICA M WALLACE LPC
S5564 COUNTY RD S
VIOLA, WI 54664-8058
Phone number: 920-309-3040
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