MR. Terry Eugene Wallace, CADC

NPI #1831304922 in Idabel, Oklahoma

Provider Information

NPI Number
1831304922
Entity Type
Individual
Name
MR. Terry Eugene Wallace, CADC
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
CADC
Enumeration Date
May 11, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
104 NE AVENUE A
City
Idabel
ZIP Code
74745
Phone
(580) 286-3301

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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