Individual
DEBRA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 REDFIELD ST, SUITE 302, DORCHESTER, MA 02122-3630
(617) 506-5160
Mailing address
50 REDFIELD ST, SUITE 302, DORCHESTER, MA 02122-3630
(617) 506-5160
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
236284
MA
Other
Enumeration date
04/17/2009
Last updated
04/17/2009
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