Individual
MRS. DEVYN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2745 S SMITHVILLE RD, DAYTON, OH 45420-2668
(937) 258-4245
Mailing address
2745 S SMITHVILLE RD, DAYTON, OH 45420-2668
(937) 258-4245
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1200675-TRNE
OH
Other
Enumeration date
01/30/2013
Last updated
02/04/2013
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