Individual
NANCY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
720 ALICEANNA ST FL 2, BALTIMORE, MD 21202-4387
(443) 923-7466
Mailing address
259 S ANN ST APT B, BALTIMORE, MD 21231-2501
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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