Individual
MS. JUDITH LYNN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4546 E 38TH PL, TULSA, OK 74135-2543
(918) 520-0352
Mailing address
4546 E 38TH PL, TULSA, OK 74135-2543
(918) 520-0352
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2492
OK
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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