Wallace, Jennifer

Wallace, Jennifer is an sole proprietor health care provider with primary practice located at 110 Samaritan Dr Suite 110, Cumming GA 30040-2535. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wallace, Jennifer can be contacted via phone (888) 850-4891.

Contact Information

Primary practice address
110 Samaritan Dr Suite 110 Cumming GA 30040-2535
Phone: (888) 850-4891
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC007671 Georgia

Profile Details

NPI number 1013389113
LBN Legal business name Wallace, Jennifer
Credentials MS, LPC, RPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 28th, 2015
Last updated Oct 28th, 2015 - about 11 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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