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Organization
WALLACE ANDREWS LLC
Active
Organization
WALLACE ANDREWS LLC
Active
Other names
WALLACE ANDREWS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLACE CLYDE ANDREWS III BEHAVIORAL HEALTH (BHT/FACILITATOR/WELLNESS COACH)
(480) 925-1393
Entity
Organization
Contact information
Practice address
1121 W BELL RD STE 373, PHOENIX, AZ 85023-3516
(480) 925-1393
Mailing address
1453 N DYSART RD STE 322, AVONDALE, AZ 85323-1539
(480) 925-1393
Taxonomy
Speciality
Code
Description
License number
State
102X00000X
Poetry Therapist
—
—
106S00000X
Behavior Technician
Primary
—
—
171400000X
Health & Wellness Coach
—
—
225800000X
Recreation Therapist
—
—
253Z00000X
In Home Supportive Care Agency
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
Other
Enumeration date
06/28/2023
Last updated
06/29/2023
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