Susan K Wallace IV
Susan K Wallace IV is a Mental Health Counselor in Bend, Oregon. Practices as a sole proprietor. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
63360 NW Britta St Ste 1Bend, OR 97701-9475
Phone: (541) 318-4845
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1679778914 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | June 18, 2007 |
| Last updated in NPPES | July 20, 2007 |
| Mailing address | 21865 Bear Creek Rd, Bend, OR 97701-9660 |
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