Wallace, Kanishia

Wallace, Kanishia is an individual health care provider with primary practice located at 500 Fairway Dr Ste 102 , Deerfield Beach FL 33441-1817. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wallace, Kanishia can be contacted via phone (888) 880-9270.

Contact Information

Primary practice address
500 Fairway Dr Ste 102 Deerfield Beach FL 33441-1817
Phone: (888) 880-9270
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1023413515
LBN Legal business name Wallace, Kanishia
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2014
Last updated May 3rd, 2019 - about 7 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