MANDI DANIELLE WALLACE

PORTLAND, OR
NPI1992367916
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2019-06-29
Last Update Date2024-01-08
Business Address
MANDI DANIELLE WALLACE
32 NE 11TH AVE
PORTLAND, OR 97232-3001
Phone number: 503-542-7635
Mailing Address
MANDI DANIELLE WALLACE
32 NE 11TH AVE
PORTLAND, OR 97232-3001
Phone number: 503-542-7635