Wallace, Jerron
Wallace, Jerron is an sole proprietor health care provider with primary practice located at 912 1St St Nw , Albuquerque NM 87102-2355. 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. Wallace, Jerron can be contacted via phone (505) 224-9777.Contact Information
Primary practice address
912 1St St Nw
Albuquerque NM 87102-2355
Phone: (505) 224-9777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | X-09336 | New Mexico |
Profile Details
| NPI number | 1033589247 |
|---|---|
| LBN Legal business name | Wallace, Jerron |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2015 |
| Last updated | Jan 19th, 2017 - about 8 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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