Individual provider · Type 1 NPI

Karen Wallace

Developmental Therapist · St. Augustine, FL

NPI number 1568655348 Active

Practice location

111 Nature Walk Pkwy, Suite 101
St. Augustine, FL 32092-5073

Call (904) 230-7761 Map

Fax (904) 230-7763

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1568655348

Karen Wallace's National Provider Identifier is 1568655348, issued on Aug 24, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in St. Augustine, FL. The record was last updated on Aug 24, 2007.