Individual provider · Type 1 NPI
Prestyne S. Wallace
Professional Counselor · Milwaukee, WI
NPI number
1003619586
Active
Practice location
2809 N 52nd St
Milwaukee, WI 53210-1608
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
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About NPI 1003619586
Prestyne S. Wallace's National Provider Identifier is 1003619586, issued on Mar 31, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Milwaukee, WI. The record was last updated on Mar 31, 2025.