Wallace, O'Keith
Wallace, O'Keith is an sole proprietor health care provider with primary practice located at 4830 Lawrenceville Hwy Nw Ste 2B , Lilburn GA 30047-3812. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Wallace, O'Keith can be contacted via phone (770) 676-9216.Contact Information
Primary practice address
4830 Lawrenceville Hwy Nw Ste 2B
Lilburn GA 30047-3812
Phone: (770) 676-9216
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1316560659 |
|---|---|
| LBN Legal business name | Wallace, O'Keith |
| Credentials | BS, MS, CAMS11 |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 21st, 2020 |
| Last updated | May 21st, 2020 - about 6 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.
Popular Providers
-
Jones, Juanita Carmella
1310 N Hearne Ave , Shreveport LA 71107-6516 -
Winbush, Judi Michelle
1373 Crooked Tree Ct Sw , Lilburn GA 30047-2433 -
Dickerson, Asha S
10 Cross Creek Dr , Lilburn GA 30047-7054 -
Manuel, Ameleo D
4566 Lawrenceville Hwy Nw Ste 101 , Lilburn GA 30047 -
Loud, Kenneth Michael
2165 N Decatur Rd , Decatur GA 30033-5307 -
Sullivan, Jessica Daniela
3161 Royal Creek Way Sw , Lilburn GA 30047-1884 -
Halczak, Roxanne
1711 3Rd St , Eureka CA 95501-0714 -
Fleurancois, Alain Emmanuel
1269 Renee Dr Sw , Lilburn GA 30047-4339