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Individual

ALLISON WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, MFT

Contact information

Practice address
2456 HEARTHSTEAD LN, CINCINNATI, OH 45239-6616
(404) 798-1055
Mailing address
2456 HEARTHSTEAD LN, CINCINNATI, OH 45239-6616
(404) 798-1055

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW005555
GA
1041C0700X
Clinical Social Worker
Primary
I.1600716
OH

Other

Enumeration date
03/08/2017
Last updated
03/08/2017
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