ICELINN WALLACE

Social Worker

Active Individual
NPI: 1376778100

Practice Address

70 LAFAYETTE ST
Pontiac, MI 48342

Phone: (248) 338-7458

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

Nearby Providers