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Individual

BAILEY J WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1040 WISHARD BLVD, INDIANAPOLIS, IN 46202-2872
(317) 962-8893
Mailing address
3434 HOLLANSBURG SAMPSON RD, GREENVILLE, OH 45331-9721

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33010358A
IN
104100000X
Social Worker
S.2208499
OH

Other

Enumeration date
05/30/2023
Last updated
05/30/2023
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