Individual
AUDRA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6183 PASEO DEL NORTE STE 140, CARLSBAD, CA 92011-1151
(760) 942-8663
Mailing address
6183 PASEO DEL NORTE STE 140, CARLSBAD, CA 92011-1151
(760) 942-8663
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CA
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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