Individual
JESSICA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3495 BUTLER ST STE 3, PITTSBURGH, PA 15201-1375
(412) 857-3717
Mailing address
81 GREENBUSH ST, PITTSBURGH, PA 15211-2023
(814) 285-2092
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW142886
PA
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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