Individual provider · Type 1 NPI

Jill Wallace

Professional Counselor · Wauwatosa, WI

NPI number 1871240978 Active

Practice location

2600 N Mayfair Rd Ste 400
Wauwatosa, WI 53226-1306

Call (414) 933-9390 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Poetry Therapist 102X00000XNone listed
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1871240978

Jill Wallace's National Provider Identifier is 1871240978, issued on Mar 8, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Wauwatosa, WI. The record was last updated on Mar 8, 2022.