JUDITH WALLACE MAC LAT NPI 1205373107

NPI Information

NPI: 1205373107
Provider Name: JUDITH WALLACE, MAC, LAT
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1221 W 5TH ST
SHERIDAN, WY
ZIP 82801
Phone: (307) 674-4405
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Judith Wallace, MAC, LAT is a mental health counselor in Sheridan, WY. Judith Wallace, MAC, LAT NPI is 1205373107. 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:

1221 W 5TH ST
SHERIDAN, WY
ZIP 82801-701
Phone: (307) 674-4405

The enumeration date for this NPI number is 1/30/2017 and was last updated on 4/6/2023.

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)	352	WYOMING	No
2	171100000X	Acupuncturist		A-030	WYOMING	No
3	101YM0800X	Counselor	Mental Health	1359	WYOMING	Yes

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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