Individual
MRS. JANELLE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4622 WICKLOW DR, MIDDLETOWN, OH 45042-2969
(513) 435-4179
Mailing address
4622 WICKLOW DR, MIDDLETOWN, OH 45042-2969
(513) 435-4179
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.004979
—
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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