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Marie Renee Wallace
Mental Health Counselor in Chico, California
NPI 1033591045

Marie Renee Wallace is a Mental Health Counselor based in Chico, CA and is specialized in Mental Health. Marie Renee Wallace practices in Chico, CA. The NPI Number for Marie Renee Wallace is 1033591045 and holds a License No. (California).

The current practice location address for Marie Renee Wallace is 289 Rio Lindo Ave, Chico, CA and can be reached out via phone at 530-896-1920.

Location: 289 Rio Lindo Ave, Chico, CA, 95926-1973
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033591045
Provider Name
Marie Renee Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
289 Rio Lindo Ave, Chico, CA, 95926-1973
Phone Number
530-896-1920
Fax Number
Provider Enumeration Date
06/25/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1033591045 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
289 Rio Lindo Ave
City
Chico
State
California
Zip
95926-1973
Phone Number
530-896-1920
Fax Number
person
Provider Business Mailing Address Details
Address
289 Rio Lindo Ave
City
Chico
State
California
Zip
95926-1973
Phone Number
530-896-1920
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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