Brandies, Wallace Edward
Brandies, Wallace Edward is an individual health care provider with primary practice located at 1717 Taylor Ave , Racine WI 53403-2405. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Brandies, Wallace Edward can be contacted via phone (262) 638-6635.Contact Information
Primary practice address
1717 Taylor Ave
Racine WI 53403-2405
Phone: (262) 638-6635
Fax: (262) 638-6540
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15295-132 | Wisconsin |
Profile Details
| NPI number | 1811595671 |
|---|---|
| LBN Legal business name | Brandies, Wallace Edward |
| Credentials | CSAC ICS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2020 |
| Last updated | Oct 14th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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