Individual
MRS. JANE ANN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2201 RIDGEWOOD RD, SUITE 400, WYOMISSING, PA 19610-1189
(610) 378-9601
Mailing address
2201 RIDGEWOOD RD, SUITE 400, PO BOX 6977, WYOMISSING, PA 19610-1189
(610) 378-9601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC004458
PA
Other
Enumeration date
02/21/2008
Last updated
06/29/2010
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