Individual
JOLENE C WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COMS
Contact information
Practice address
110 APPLE HOUSE LN, MISSOULA, MT 59802-3324
(406) 360-9480
(406) 549-3581
Mailing address
110 APPLE HOUSE LN, MISSOULA, MT 59802-3324
(406) 360-9480
(406) 549-3581
Taxonomy
Speciality
Code
Description
License number
State
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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