Individual provider · Type 1 NPI

Brian Wallace

Addiction (Substance Use Disorder) Counselor · Upland, CA

NPI number 1437879418 Active

Practice location

239 W 9th St
Upland, CA 91786-5979

Call (909) 920-5102 Map

Mailing address

762 North Rd
San Bernardino, CA 92404-2439

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1437879418

Brian Wallace's National Provider Identifier is 1437879418, issued on Aug 31, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Upland, CA. The record was last updated on Aug 31, 2022.