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1972936425
JAN ELLEN WALLACE
TUCSON, AZ
NPI
1972936425
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AZ LCSW-1647)
Enumeration Date
2013-08-19
Last Update Date
2013-08-19
Business Address
Ms. JAN ELLEN WALLACE LCSW
140 N TUCSON BLVD
TUCSON, AZ 85716-4740
Phone number: 520-396-1021
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Mailing Address
Ms. JAN ELLEN WALLACE LCSW
140 N TUCSON BLVD
TUCSON, AZ 85716-4740
Phone number: 520-396-1021
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