Individual
CYNTHIA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
(330) 452-9812
Mailing address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
(330) 452-9812
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.1201126
OH
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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