Individual provider · Type 1 NPI

Susan R. Wallace

Mental Health Counselor · Chicago, IL

NPI number 1043958176 Active

Practice location

2715 N Central Ave
Chicago, IL 60639-1351

Mailing address

86 E 13th St
Chicago Heights, IL 60411-2761

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1043958176

Susan R. Wallace's National Provider Identifier is 1043958176, issued on May 27, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on May 27, 2022.