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Individual
MR. STEVEN LANE WALLACE
Active
Individual
MR. STEVEN LANE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC61453392
WA
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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