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Individual

MS. DONNA LEE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT/L

Contact information

Practice address
5600 CYPRESSWOOD DR, SPRING, TX 77379-8260
(832) 559-7767
(832) 559-7767
Mailing address
5600 CYPRESSWOOD DR, SPRING, TX 77379-8260
(832) 559-7767
(832) 559-7767

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
101953
TX

Other

Enumeration date
03/23/2012
Last updated
03/23/2012
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