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Individual

CAITLYN WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3910 OLD BUCKINGHAM RD, POWHATAN, VA 23139-5757
(804) 598-2200
Mailing address
3910 OLD BUCKINGHAM RD STE A, POWHATAN, VA 23139-5757

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904019712
VA

Other

Enumeration date
12/29/2025
Last updated
12/31/2025
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