Organization
ANGELA K WALLACE, MFT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA K WALLACE LMFT (PSYCHOTHERAPIST)
(323) 270-5437
Entity
Organization
Contact information
Practice address
554 S SAN VICENTE BLVD STE 200, LOS ANGELES, CA 90048-4651
(323) 270-5437
Mailing address
554 S SAN VICENTE BLVD STE 200, LOS ANGELES, CA 90048-4651
(323) 270-5437
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
45450
CA
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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