Individual
CONSTANCE ALBERTA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1836 FREMONT ST, ASHLAND, OR 97520-2537
(541) 414-1720
Mailing address
1482 WOODLAND DR, ASHLAND, OR 97520-3452
(541) 625-9336
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
12/31/2025
Last updated
12/31/2025
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