Individual
MS. JESSIE LIN WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1019 NORTHSIDE SHOPPING CTR, ONEIDA, NY 13421-4901
(315) 361-9131
(315) 361-4526
Mailing address
501 W GENESEE ST, APT 38, CHITTENANGO, NY 13037-1071
(315) 361-9131
(315) 361-4526
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/26/2010
Last updated
01/26/2010
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