Individual provider · Type 1 NPI
Jennifer Renea Wallace, B.A
Counselor · Durant, OK
NPI number
1669799086
Active
Practice location
3802 W University Blvd Apt 8104
Durant, OK 74701-3047
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | None listed |
Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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About NPI 1669799086
Jennifer Renea Wallace, B.A's National Provider Identifier is 1669799086, issued on Apr 24, 2010. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Durant, OK. The record was last updated on Apr 24, 2010.