Brian Wallace
Brian Wallace is an Addiction (Substance Use Disorder) Counselor in Upland, California. Practices as a sole proprietor. Licensed in California.
- Licensed in
- CA
- In the registry since
- 2022
Practice location Address checks out
239 W 9th StUpland, CA 91786-5979
Phone: (909) 920-5102
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X (CA) |
|---|
Record details
| NPI number | 1437879418 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | August 31, 2022 |
| Last updated in NPPES | August 31, 2022 |
| Certification date | August 31, 2022 |
| Mailing address | 762 North Rd, San Bernardino, CA 92404-2439 |
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