Individual
MISS KAREN ELYSE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
439 W 97TH ST, LOS ANGELES, CA 90003-3968
(323) 754-2856
Mailing address
PO BOX 5708, GARDENA, CA 90249-5708
(323) 750-5167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCS 21147
CA
1041S0200X
School Social Worker
Primary
LCS 21147
CA
Other
Enumeration date
03/27/2007
Last updated
09/11/2025
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