PRESTYNE S. WALLACE
NPI 1003619586
Counselor - Professional in Milwaukee, WI
Active since March 31, 2025
About Prestyne S. Wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRESTYNE S. WALLACE (NPI 1003619586) is an individual professional provider in Milwaukee, Wisconsin and active in the NPI registry since March 2025.
NPPES Registry Identity
NPI1003619586
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NamePRESTYNE S. WALLACE
Location Address2809 N 52ND STMilwaukee, WI 53210-1608
Mailing Address2809 N 52nd StMilwaukee, WI 53210-1608 · (414) 732-9938
Phone(414) 732-9938
Sole ProprietorYes
Enumeration DateMarch 31, 2025
NPPES CertifiedMarch 30, 2025
✔ NPI 1003619586 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
2809 N 52ND ST, Milwaukee, WI 53210
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003619586, enumerated as an "individual" on March 31, 2025.
The provider is located at 2809 N 52ND ST MILWAUKEE, WI 53210 and the phone number is (414) 732-9938.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
