Individual provider · Type 1 NPI

Kathleen Wallace

Professional Counselor · Clinton Township, MI

NPI number 1508794637 Active

Practice location

15600 19 Mile Rd
Clinton Township, MI 48038-3502

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1508794637

Kathleen Wallace's National Provider Identifier is 1508794637, issued on May 11, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Clinton Township, MI. The record was last updated on May 11, 2026.