Individual provider · Type 1 NPI
Katherine Sue Wallace, MS
Addiction (Substance Use Disorder) Counselor · Gideon, MO
NPI number
1942583893
Active
Practice location
408 S Gideon Ave
Gideon, MO 63848-9200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 6385 (MO) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1942583893
Katherine Sue Wallace, MS's National Provider Identifier is 1942583893, issued on Sep 27, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gideon, MO. The record was last updated on Sep 27, 2011.