Individual
HEIDI L WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, CDCA
Contact information
Practice address
824 BOWTOWN RD, DELAWARE, OH 43015-9661
(740) 369-7688
(740) 363-6415
Mailing address
824 BOWTOWN RD, DELAWARE, OH 43015-9661
(740) 369-7688
(740) 363-6415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.1201513
OH
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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