Individual
TRUDY A WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15303 ST. RT 170, EAST LIVERPOOL, OH 43920-9216
(330) 385-1000
(330) 385-3588
Mailing address
1029 EPHRIAM ST, EAST LIVERPOOL, OH 43920-4124
(330) 708-3175
(330) 385-3588
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/05/2007
Last updated
10/30/2008
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