Individual
MARILYN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 MARSH AVE, CINCINNATI, OH 45212-4218
(513) 344-6196
Mailing address
2611 MARSH AVE, CINCINNATI, OH 45212-4218
(513) 344-6196
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
—
OH
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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