Individual
DANIEL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, LCSW
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 792-1450
Mailing address
2641 W CAMINO DEL VENEGAS, TUCSON, AZ 85742-9287
(602) 373-4672
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
1041C0700X
Clinical Social Worker
149.024518
IL
Other
Enumeration date
05/08/2018
Last updated
06/03/2022
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