Individual
CHRYSANTHY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
135 N PARKE ST, ABERDEEN, MD 21001-2428
(443) 625-1600
Mailing address
135 N PARKE ST, ABERDEEN, MD 21001-2428
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22402
MD
Other
Enumeration date
12/07/2016
Last updated
05/08/2019
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