MR. Andrew Anthony Wallace SR.
NPI #1174856587 in Colton, California
Provider Information
- NPI Number
- 1174856587
- Entity Type
- Individual
- Name
- MR. Andrew Anthony Wallace SR.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Enumeration Date
- Sep 16, 2009
- Last Updated
- Sep 16, 2009
Practice Location
- Address
- 1076 SANTO ANTONIO DR
- Address 2
- SUITE B
- City
- Colton
- State
- California
- ZIP Code
- 92324-8103
- Phone
- (909) 433-9824
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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