MR. BENNETT WALLACE, M.S.S.W

Social Worker - Clinical

Active Individual
NPI: 1699042788

Practice Address

164 E ASHLAND AVE
Louisville, KY 40214

Phone: (502) 693-2606

Specialties

Specialty Code Primary License
Social Worker - Clinical 1041C0700X Yes 3772 (KY)

Frequently Asked Questions

NPI 1699042788 is the National Provider Identifier for MR. BENNETT WALLACE, M.S.S.W, a Social Worker - Clinical provider located in Louisville, KY. This NPI was enumerated on November 17, 2011.
MR. BENNETT WALLACE, M.S.S.W practices at 164 E ASHLAND AVE, Louisville, KY 40214.

Quick Facts

NPI
1699042788
Type
Individual
Enumerated
Nov 17, 2011
Last Updated
Nov 17, 2011

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