ICELINN WALLACE
Social Worker
Active
Individual
NPI: 1376778100
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Social Worker | 104100000X | Yes | 680109826 (MI) |
Frequently Asked Questions
NPI 1376778100 is the National Provider Identifier for ICELINN WALLACE, a Social Worker provider located in Pontiac, MI. This NPI was enumerated on May 22, 2009.
ICELINN WALLACE practices at 70 LAFAYETTE ST, Pontiac, MI 48342.
Quick Facts
- NPI
- 1376778100
- Type
- Individual
- Enumerated
- May 22, 2009
- Last Updated
- May 22, 2009
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