Individual
DARCIE MARILYN PRICE-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3330 OLD GLENVIEW RD, SUITE 1, WILMETTE, IL 60091-2963
(773) 988-5820
Mailing address
1503 OAK AVE APT 213, EVANSTON, IL 60201-4223
(773) 988-5820
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.011665
IL
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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