Individual
DONIELLE R WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 DANA AVE STE 220, CINCINNATI, OH 45207-1342
(216) 468-5000
Mailing address
207D COLEGATE DR, MARIETTA, OH 45750-2363
(740) 376-0930
(740) 376-0933
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1904386
OH
1041C0700X
Clinical Social Worker
Primary
I.2405894
OH
Other
Enumeration date
05/07/2020
Last updated
03/10/2025
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