Individual
CHRISTOPHER WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1790 N STATE ST, OREM, UT 84057-2025
(801) 224-8255
(801) 224-8301
Mailing address
1790 N STATE ST, OREM, UT 84057-2025
(801) 224-8255
(801) 224-8301
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
115169-3902
UT
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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