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Individual

JOHN H WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
5134 CEDAR VILLAGE DR, MASON, OH 45040-3717
(513) 229-7900
Mailing address
208 BAXTER AVE, CINCINNATI, OH 45220-1302
(513) 861-4977

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E0000844
OH

Other

Enumeration date
12/17/2007
Last updated
12/17/2007
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