Individual
MS. KATHERINE LEE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1200 E MARSHALL ST, RICHMOND, VA 23298-5023
(804) 297-5797
Mailing address
2218 PARKWOOD AVE FL 2, RICHMOND, VA 23220-5207
(703) 785-5744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904012660
VA
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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