Individual
PAMELA JENE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELORS, RADT
Contact information
Practice address
1331 W AVENUE J STE 103, LANCASTER, CA 93534-2946
(661) 579-3191
Mailing address
1331 W AVENUE J STE 103, LANCASTER, CA 93534-2946
(661) 579-3191
(661) 522-3130
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
R1465460422
CA
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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