Wallace, Jessica

Wallace, Jessica is an sole proprietor health care provider with primary practice located at 75 Grand Ave , Massapequa NY 11758-4905. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Wallace, Jessica can be contacted via phone (516) 799-3203.

Contact Information

Primary practice address
75 Grand Ave Massapequa NY 11758-4905
Phone: (516) 799-3203
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 117144 New York

Profile Details

NPI number 1649751801
LBN Legal business name Wallace, Jessica
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 26th, 2018
Last updated Apr 14th, 2025 - about last year

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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