Individual provider · Type 1 NPI

Cynthia Elaine Fay Wallace

Peer Specialist · Grand Rapids, MI

NPI number 1437019924 Active

Practice location

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Call (616) 456-6571 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1437019924

Cynthia Elaine Fay Wallace's National Provider Identifier is 1437019924, issued on Nov 17, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 9, 2025.