Shannon Wallace is a specialist in Bellerose, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Shannon Wallace NPI is 1588142574. 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:
8777 254TH ST
BELLEROSE, NY
ZIP 11426-329
Phone: (347) 324-2766
The enumeration date for this NPI number is 8/1/2018 and was last updated on 9/13/2018.