Individual provider · Type 1 NPI

Mallory Wallace

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Cincinnati, OH

NPI number 1972207504 Active

Practice location

8725 Brooks Creek Dr Apt 2125
Cincinnati, OH 45249-2089

Call (424) 333-5672 Map

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000XNone listed

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1972207504

Mallory Wallace's National Provider Identifier is 1972207504, issued on Mar 28, 2023. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Cincinnati, OH. The record was last updated on Mar 28, 2023.