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Individual

DR. ANNE M. WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
3327 ORION AVE, CINCINNATI, OH 45213-1707
(513) 531-6116
(513) 531-4640
Mailing address
3327 ORION AVE, CINCINNATI, OH 45213-1707
(513) 531-6116
(513) 531-4640

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
1240
KY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5360
OH

Other

Enumeration date
01/28/2008
Last updated
01/28/2008
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