Individual
LUCIANA A WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
575 S 19TH ST, NEWARK, NJ 07103-1109
(973) 626-1800
Mailing address
575 S 19TH ST, NEWARK, NJ 07103-1109
(973) 626-1800
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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