Individual
JOSLYN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2023002802
MO
1041C0700X
Clinical Social Worker
149.031259
IL
Other
Enumeration date
10/30/2023
Last updated
02/25/2026
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