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Individual

BRYNN WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
308 E 38TH ST, NEW YORK, NY 10016-9819
(917) 773-7694
Mailing address
49 W 24TH ST, SUITE 608, NEW YORK, NY 10010-3206
(917) 773-7694

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
083759
NY

Other

Enumeration date
04/19/2011
Last updated
04/28/2016
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