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1992125892
LISA WALLACE
JACKSONVILLE, FL
NPI
1992125892
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-04-18
Last Update Date
2015-03-26
Business Address
-- LISA WALLACE
2392 EDGEWOOD AVE N
JACKSONVILLE, FL 32254-1725
Phone number: 904-781-0600
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Mailing Address
-- LISA WALLACE
2392 EDGEWOOD AVE N
JACKSONVILLE, FL 32254-1725
Phone number:
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