Individual provider · Type 1 NPI

Constance Alberta Wallace

Mental Health Counselor · Ashland, OR

NPI number 1437015633 Active

Practice location

1836 Fremont St
Ashland, OR 97520-2537

Mailing address

1482 Woodland Dr
Ashland, OR 97520-3452

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1437015633

Constance Alberta Wallace's National Provider Identifier is 1437015633, issued on Dec 31, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ashland, OR. The record was last updated on Dec 31, 2025.