Individual
RENEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
9844 S 1300 E, SANDY, UT 84094-4673
(801) 810-5037
Mailing address
747 E VILLAGE WAY, SANDY, UT 84094-1860
(208) 201-1174
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
14028854-3502
UT
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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