Individual
LORRAINE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 BALDWIN RD STE 203C, PARSIPPANY, NJ 07054-7505
(973) 362-2091
Mailing address
259 BALDWIN RD STE 203C, PARSIPPANY, NJ 07054-7505
(733) 622-0919
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01106200
NJ
Other
Enumeration date
01/25/2021
Last updated
12/01/2021
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