NPI Index

DR. SUSAN 'SUZI' WALLACE, PHD, PT, LPC

Psychologist - Clinical

Active Individual
NPI: 1124215256

Practice Address

5111 ROGERS AVENUE, SUITE 533
CENTRAL MALL PLAZA SUITES #533
Fort Smith, AR 72903

Phone: (479) 651-7413

Specialties

Specialty Code Primary License
Counselor - Professional 101YP2500X No A0510074 (AR)
Physical Therapist 225100000X No 1724 (AR)
Psychologist - Clinical 103TC0700X Yes 18-08P (AR)

Frequently Asked Questions

NPI 1124215256 is the National Provider Identifier for DR. SUSAN 'SUZI' WALLACE, PHD, PT, LPC, a Psychologist - Clinical provider located in Fort Smith, AR. This NPI was enumerated on October 3, 2007.
DR. SUSAN 'SUZI' WALLACE, PHD, PT, LPC practices at 5111 ROGERS AVENUE, SUITE 533, CENTRAL MALL PLAZA SUITES #533, Fort Smith, AR 72903.

Quick Facts

NPI
1124215256
Type
Individual
Enumerated
Oct 3, 2007
Last Updated
Aug 30, 2018

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