Individual
DANA K. WALLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
588 MAIN ST, SHREWSBURY, MA 01545-2920
(310) 880-8889
Mailing address
588 MAIN ST, SHREWSBURY, MA 01545-2920
(310) 880-8889
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1337
MA
106H00000X
Marriage & Family Therapist
45024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1337
LMFT LICENSE
MA
01
—
45024
LMFT
CA
Enumeration date
10/24/2008
Last updated
05/25/2010
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