William Blaine-Wallace
NPI #1730612839 in Farmington, Maine
Provider Information
- NPI Number
- 1730612839
- Entity Type
- Individual
- Name
- William Blaine-Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Apr 5, 2017
- Last Updated
- Apr 5, 2017
Practice Location
- Address
- 456 NEW VINEYARD RD
- City
- Farmington
- State
- Maine
- ZIP Code
- 04938-5216
- Phone
- (207) 491-9645
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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