Mr. Andrew Anthony Wallace Sr.
Mr. Andrew Anthony Wallace Sr. is an Addiction (Substance Use Disorder) Counselor in Colton, California. Licensed in California. Registered with an NPI since 2009.
- Licensed in
- CA
- In the registry since
- 2009
Practice location Address checks out
1076 Santo Antonio Dr Ste BColton, CA 92324-8103
Phone: (909) 433-9824
Fax: (909) 433-9830
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence RS9874 (CA) |
|---|
Record details
| NPI number | 1174856587 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 16, 2009 |
| Last updated in NPPES | September 16, 2009 |
| Mailing address | 1076 Santo Antonio Dr, Suite B, Colton, CA 92324-8103 |
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Kathy Lavern Williams
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