Individual
MRS. ANGELINA VICTORIA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 RANSOM PL, NASHVILLE, TN 37217-3841
(615) 460-4357
Mailing address
8215 HALEY RD, COLLEGE GROVE, TN 37046-9112
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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