Individual provider · Type 1 NPI

Justine Wallace

Professional Counselor · Newington, CT

NPI number 1487960662 Active

Practice location

419 Cedar St
Newington, CT 06111-1812

Call (561) 271-5185 Map

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X001902 (CT)

Professional Counselor: Definition to come...

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About NPI 1487960662

Justine Wallace's National Provider Identifier is 1487960662, issued on Aug 25, 2010. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Newington, CT. The record was last updated on Aug 25, 2010.