Individual
MISS CATHERINE KELLY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 DELAWARE AVE STE 204, BUFFALO, NY 14202-1007
(716) 882-3151
(716) 886-4022
Mailing address
625 DELAWARE AVE STE 204, BUFFALO, NY 14202-1007
(716) 882-3151
(716) 886-4022
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/17/2017
Last updated
07/21/2022
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