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Individual

MRS. MOLLY WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
4777 E GALBRAITH RD, CINCINNATI, OH 45236-2725
(513) 686-3223
Mailing address
149 CIRCLE DR, HARRISON, OH 45030-2803
(513) 460-8724

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
7095
OH

Other

Enumeration date
11/17/2015
Last updated
11/17/2015
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