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Individual

JENNIFER LOUISE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSW, QMHP

Contact information

Practice address
851 WEST ST, RAPID CITY, SD 57701-2516
(605) 393-4278
Mailing address
24100 S ROCKERVILLE RD, RAPID CITY, SD 57702-7422
(605) 343-5422
(605) 343-1411

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6674
SD

Other

Enumeration date
02/06/2019
Last updated
09/10/2025
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