JILES LEE WALLACE

SAN FRANCISCO, CA
NPI1942187067
Professional NameJILES LEE WALLACE
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2025-08-20
Last Update Date2025-08-20
Business Address
-- JILES LEE WALLACE RADT
890 HAYES ST
SAN FRANCISCO, CA 94117-2615
Phone number: 415-762-3700
Mailing Address
-- JILES LEE WALLACE RADT
1563 MISSION ST
SAN FRANCISCO, CA 94103-2543
Phone number: 415-762-3700
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