person
Susan K Wallace IV
Mental Health Counselor in Bend, Oregon
NPI 1679778914

Susan K Wallace IV is a Mental Health Counselor based in Bend, OR and is specialized in Mental Health. Susan K Wallace IV practices in Bend, OR. The NPI Number for Susan K Wallace IV is 1679778914 and holds a License No. (Oregon).

The current practice location address for Susan K Wallace IV is 63360 Nw Britta St Ste 1, Bend, OR and can be reached out via phone at 541-318-4845. You can also correspond with Susan K Wallace IV through the mailing address at 21865 BEAR CREEK RD, BEND, OR - 97701-9660 (mailing address contact number: 541-318-8082).

Location: 63360 Nw Britta St Ste 1, Bend, OR, 97701-9660
person
Provider Profile Details
NPI Number
1679778914
Provider Name
Susan K Wallace IV
Credential
Provider Entity Type
Individual
Gender
Female
Address
63360 Nw Britta St Ste 1, Bend, OR, 97701-9660
Phone Number
541-318-4845
Fax Number
Provider Enumeration Date
06/18/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
63360 Nw Britta St Ste 1
City
State
Zip
97701-9475
Phone Number
541-318-4845
Fax Number
person
Provider Business Mailing Address Details
Address
63360 Nw Britta St Ste 1
City
State
Zip
97701-9475
Phone Number
541-318-4845
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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