Wallace, Debra

Wallace, Debra is an sole proprietor health care provider with primary practice located at 27979 N Converse Rd , Island Lake IL 60042-8103. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Wallace, Debra can be contacted via phone (847) 850-9444.

Contact Information

Primary practice address
27979 N Converse Rd Island Lake IL 60042-8103
Phone: (847) 850-9444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 166000901 Illinois

Profile Details

NPI number 1598005019
LBN Legal business name Wallace, Debra
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2013
Last updated Feb 20th, 2013 - about 12 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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