Individual
DEBORAH WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2460 25TH ST NE, CANTON, OH 44705-2468
(330) 809-7073
Mailing address
2460 25TH ST NE, CANTON, OH 44705-2468
(330) 809-7073
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
385H00000X
Respite Care
—
OH
Other
Enumeration date
10/27/2014
Last updated
02/03/2026
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