Individual
DEANNA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4915 CHARLESTOWN RD, NEW ALBANY, IN 47150-9426
(812) 945-5221
Mailing address
8577 CORYDON RIDGE RD, LANESVILLE, IN 47136-9434
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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