Individual provider · Type 1 NPI

Gennifer Wallace, MA

Addiction (Substance Use Disorder) Counselor · Charlestown, IN

NPI number 1598124992 Active

Practice location

7509 Charlestown Pike
Charlestown, IN 47111-9623

Call (812) 256-4686 Map

Fax (812) 256-4415

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1598124992

Gennifer Wallace, MA's National Provider Identifier is 1598124992, issued on Feb 15, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Charlestown, IN. The record was last updated on Feb 15, 2016.