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
Fax: (262) 638-6540
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Popular Providers