Individual
CHASEI WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5715 SIGNAL POINTE DR APT 102, CINCINNATI, OH 45247-3285
(513) 686-0798
Mailing address
5715 SIGNAL POINTE DR APT 102, CINCINNATI, OH 45247-3285
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
07/29/2025
Last updated
09/15/2025
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