Individual
ELENI WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
585 LINCOLN ST, WORCESTER, MA 01605-1906
(508) 831-0045
Mailing address
10 MECHANIC ST, SUITE 302, WORCESTER, MA 01608-2420
(508) 792-5400
(508) 831-0074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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