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Individual

ASHLEY E. WALLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
300 WASHINGTON AVENUE EXT., ALBANY, NY 12203
(518) 218-0000
(518) 862-2175
Mailing address
300 WASHINGTON AVENUE EXT., ALBANY, NY 12203
(518) 218-0000
(518) 862-2175

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1740206010
GROUP NPI
NY
Enumeration date
07/10/2012
Last updated
07/10/2012
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