Penny Joanne Wallace LMSW

NPI 1295948685 - Social Worker - 104100000X

NPI Details
NPI 1295948685
Gender Female
Enumeration Date 05/08/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
610 N 4TH ST
SUITE 110A RIVER PARK PLACE
BURLINGTON IA, 52601-5055, US
Phone (319) 754-9213
Fax
Business Location
115 S 7TH ST
BURLINGTON IA, 52601-5407, US
Phone (319) 754-6560
Fax
Toxanomy
Taxonomy Code 104100000X
License State Iowa
License Number 06804
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According to our database, Penny Joanne Wallace LMSW NPI is 1295948685, taxonomy code is 104100000X and license number is 06804, license state is located at Iowa. Penny Joanne Wallace LMSW physically located at 610 N 4th St, Burlington IA, 52601-5055. NPI Number Penny Joanne Wallace LMSW has the Individual type.

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1295948685 NPI number is provided on an as is basis without warranty of any kind. 1295948685 is maintained by the National Plan & Provider Enumeration System. The contents of Penny Joanne Wallace LMSW are for informational purposes only.