Wallace, Kimberly
Wallace, Kimberly is an individual health care provider with primary practice located at 600 E Carmel Dr Suite 143, Carmel IN 46032-2803. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Wallace, Kimberly can be contacted via phone (317) 730-5155.Contact Information
Primary practice address
600 E Carmel Dr Suite 143
Carmel IN 46032-2803
Phone: (317) 730-5155
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1629301353 |
|---|---|
| LBN Legal business name | Wallace, Kimberly |
| Credentials | LMFT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2009 |
| Last updated | Dec 31st, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629301353 | NPPES |
| Indiana | MEDICAID | 100270530A |
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