Individual
JESSICA WALLER WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
317 DARTMOUTH DRIVE, BLDG 4, UNIT 3, MARSHALLS CREEK, PA 18335
(570) 730-4211
Mailing address
317 DARTMOUTH DRIVE, BLDG 4, UNIT 3, MARSHALLS CREEK, PA 18335
(570) 730-4211
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW134964
PA
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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