Individual
ASHLEY D WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PLPC
Contact information
Practice address
777 E BATTLEFIELD ST, SPRINGFIELD, MO 65807-4807
(417) 597-4572
Mailing address
777 E BATTLEFIELD ST, SPRINGFIELD, MO 65807-4807
(417) 597-4572
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014001278
MO
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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