Laurel Lynn Wallace
NPI #1881337319 in Enterprise, Oregon
Provider Information
- NPI Number
- 1881337319
- Entity Type
- Individual
- Name
- Laurel Lynn Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Peer Specialist
- Enumeration Date
- Apr 13, 2022
- Last Updated
- Aug 8, 2022
Practice Location
- Address
- 606 MEDICAL PKY
- City
- Enterprise
- State
- Oregon
- ZIP Code
- 97828
- Phone
- (541) 426-4524
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
| Case Manager/Care Coordinator |
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