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Organization
CONNIE WALLAE
Active
Organization
CONNIE WALLAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE WALLACE MFT (MFT)
(661) 205-1522
Entity
Organization
Contact information
Practice address
1706 CHESTER AVE, SUITE 340, BAKERSFIELD, CA 93301-5242
(661) 205-1522
(661) 873-0515
Mailing address
1706 CHESTER AVE, SUITE 340, BAKERSFIELD, CA 93301-5242
(661) 205-1522
(661) 873-0515
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC 40616
CA
Other
Enumeration date
07/20/2006
Last updated
08/08/2008
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