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Individual

DR. COURTNEY NICOLE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD, CCC-A, F/AAA

Contact information

Practice address
2530 CHICAGO AVE STE 450, MINNEAPOLIS, MN 55404-4127
(612) 813-7610
Mailing address
202 7TH ST W APT 515, SAINT PAUL, MN 55102-3094
(630) 303-3209

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary

Other

Enumeration date
06/19/2017
Last updated
07/21/2022
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