Individual
VICTORIA LEE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 VICTORIA ST, APT. 1002, HONOLULU, HI 96814-1048
(808) 675-6200
Mailing address
1314 VICTORIA ST, APT. #1002, HONOLULU, HI 96814-1048
(808) 675-6200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1874
HI
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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