Individual
DANIELA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4041 S MCCLINTOCK DR, TEMPE, AZ 85282-5879
(480) 401-5086
Mailing address
4041 S MCCLINTOCK DR, TEMPE, AZ 85282-5879
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
163WC1500X
AZ
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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