Dedra Wallace is a professional counselor in Pueblo, CO. Dedra Wallace NPI is 1063810877. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
1302 CHINOOK LN
PUEBLO, CO
ZIP 81001-851
Phone: (719) 545-2746
Fax: (719) 545-4100
The NPI 1063810877 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.
The enumeration date for this NPI number is 12/10/2014 and was last updated on 10/19/2016.