Josephine Wallace's National Provider Identifier (NPI) Details
Josephine Wallace, MFTI
NPI: 1912242975
Enumeration Date: 2012-12-03
Last updated: 2012-12-03
Sole Proprietor: NO
Status: active
Postal Address: 4760 SEPULVEDA BLVD, CULVER CITY, CA
Phone: 310-390-6612
Primary Practice Address: 672 S LA FAYETTE PARK PL, SUITE 6, LOS ANGELES, CA
Practice's phone: 213-381-3626