Individual provider · Type 1 NPI

Laurel Lynn Wallace

Peer Specialist · Enterprise, OR

NPI number 1881337319 Active

Practice location

606 Medical Pky
Enterprise, OR 97828

Call (541) 426-4524 Map

Mailing address

405 NW 2nd St
Enterprise, OR 97828-1014

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1881337319

Laurel Lynn Wallace's National Provider Identifier is 1881337319, issued on Apr 13, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Enterprise, OR. The record was last updated on Aug 8, 2022.