Individual
AMANDA ROCHELLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
885 NW GRANT AVE, CORVALLIS, OR 97330-4578
(541) 752-2703
(541) 368-7690
Mailing address
885 NW GRANT AVE, CORVALLIS, OR 97330-4578
(541) 752-2703
(541) 368-7690
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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