JUSTINE WALLACE
NPI 1487960662
Counselor - Professional in Newington, CT
- Individual
- Female
- Counselor
- Professional
About JUSTINE WALLACE
This page provides the complete NPI Profile along with additional information for Justine Wallace, a provider established in Newington, Connecticut with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1487960662 assigned on August 2010. The practitioner's primary taxonomy code is 101YP2500X with license number 001902 (CT). The provider is registered as an individual and her NPI record was last updated 16 years ago.
- NPI
- 1487960662 Verify this NPI
- Provider Name
- JUSTINE WALLACE
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 419 CEDAR ST NEWINGTON, CT 06111
- Location Phone
- (561) 271-5185
- Mailing Address
- 419 CEDAR ST NEWINGTON, CT 06111
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-25-2010
- Last Update Date
- 08-25-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 001902
- License State
- CT
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487960662, enumerated as an "individual" on August 25, 2010.
The provider is located at 419 CEDAR ST NEWINGTON, CT 06111 and the phone number is (561) 271-5185.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
