Individual
DANIELLE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-T.
Contact information
Practice address
1029 W DOUGLAS AVE STE 211, WICHITA, KS 67213-4756
(316) 542-1120
(315) 462-0543
Mailing address
410 S MAIN ST, CHENEY, KS 67025-8698
(316) 542-1120
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14442
KS
Other
Enumeration date
07/07/2025
Last updated
05/21/2026
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