Individual
WALLACE A BEAUCHAMP III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1475 N ORACLE RD, TUCSON, AZ 85705-7236
(520) 624-5806
(520) 624-5817
Mailing address
3130 E BROADWAY BLVD, STE. 180, TUCSON, AZ 85716-5863
(520) 624-5806
(520) 624-5817
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 11576
AZ
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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