Individual
MONICA JOYCE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21862 STATE HIGHWAY 59 S, ROBERTSDALE, AL 36567-6711
(901) 949-9459
Mailing address
21862 HWY 59, ROBERTSDALE, AL 36567
(901) 949-9459
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
AL
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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