Individual
CRISHA MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
813 BRYDEN RD, COLUMBUS, OH 43205-1759
(614) 808-3198
Mailing address
1480 MARSDALE AVE, COLUMBUS, OH 43223-3752
(614) 257-8436
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA191110
OH
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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