Individual
ASHNA KYLA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2112 S CONGRESS AVE STE 104, PALM SPRINGS, FL 33406-7670
(561) 653-6292
Mailing address
2112 S CONGRESS AVE STE 104, PALM SPRINGS, FL 33406-7670
(561) 653-6292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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