MRS. JENNIFER M. WALLACE M.ED NPI 1093927907

NPI Information

NPI: 1093927907
Provider Name: MRS. JENNIFER M. WALLACE, M.ED
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2298 W HORIZON RIDGE PKWY
SUITE 109
HENDERSON, NV
ZIP 89052
Phone: (702) 363-7284
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MRS. Jennifer M. Wallace, M.ED is an addiction (substance use disorder) counselor in Henderson, NV. MRS. Jennifer M. Wallace, M.ED NPI is 1093927907. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2298 W HORIZON RIDGE PKWY
SUITE 109
HENDERSON, NV
ZIP 89052-696
Phone: (702) 363-7284
Fax: (702) 242-5252

The enumeration date for this NPI number is 5/4/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1118L	NEVADA	Yes
2	104100000X	Social Worker		00561-A	NEVADA	X
3	106H00000X	Marriage & Family Therapist		R05387	NEVADA	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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