Individual provider · Type 1 NPI
Richard J. Wallace, MASTER
Mental Health Counselor · Berkeley, CA
NPI number
1326199043
Active
Practice location
1930 Stuart St
Berkeley, CA 94703-2215
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1326199043
Richard J. Wallace, MASTER's National Provider Identifier is 1326199043, issued on Jan 16, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Berkeley, CA. The record was last updated on Jul 8, 2007.