Individual
KATHERINE MELISSA AINSLIE-WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
175 W B ST STE H, SPRINGFIELD, OR 97477-4575
(541) 423-2633
Mailing address
175 W B ST STE H, SPRINGFIELD, OR 97477-4575
(541) 423-2633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3845-226
WI
101YP2500X
Professional Counselor
Primary
C6261
OR
Other
Enumeration date
03/02/2018
Last updated
06/04/2022
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