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1992444954
LYLE G WALLACE
WEST ORANGE, NJ
NPI
1992444954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041S0200X Social Worker School
(Licence: NJ 44SL04765500)
Enumeration Date
2022-05-29
Last Update Date
2022-05-29
Business Address
LYLE G WALLACE
36 WALKER RD
WEST ORANGE, NJ 07052-4403
Phone number: 973-715-5591
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Mailing Address
LYLE G WALLACE
36 WALKER RD
WEST ORANGE, NJ 07052-4403
Phone number: 973-715-5591
Copy
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