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Individual

BETTY WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3688 WALES DR, DAYTON, OH 45405-1845
(502) 912-2674
Mailing address
3688 WALES DR, DAYTON, OH 45405-1845
(502) 912-2674

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
923242
OH

Other

Enumeration date
08/10/2015
Last updated
04/08/2019
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