Individual
DEBORAH JEAN CARPENTER WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3 COURTHOUSE LANE SUITE 3, CHELMSFORD, MA 01824
(978) 256-1444
(978) 441-1773
Mailing address
4401 PARK ROAD 21, CLEBURNE, TX 76033-8561
(817) 875-0144
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
110823
MA
1041C0700X
Clinical Social Worker
Primary
50563
TX
1041C0700X
Clinical Social Worker
9859-C
NV
Other
Enumeration date
10/20/2006
Last updated
03/17/2023
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