Individual
BONNIE JEAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
205 SCHOOL ST., # 202, GARDNER, MA 01440
(978) 632-2321
Mailing address
PO BOX 37, FITZWILLIAM, NH 03447-0037
(603) 585-9010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/31/2017
Last updated
05/31/2017
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