Individual
MS. BRENNA MICHEL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
8220 CASTOR AVE, PHILA, PA 19152-2729
(215) 847-2249
(215) 745-6511
Mailing address
8220 CASTOR AVE, PHILA, PA 19152-2729
(215) 847-2249
(215) 745-6511
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/13/2013
Last updated
07/02/2013
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