LYLE G WALLACE
NPI 1992444954
Social Worker - School in West Orange, NJ
Active since May 29, 2022
About Lyle G Wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LYLE G WALLACE (NPI 1992444954) is an individual school provider in West Orange, New Jersey, licensed in New Jersey (44SL04765500) and active in the NPI registry since May 2022.
NPPES Registry Identity
NPI1992444954
Entity TypeIndividualMale
Primary Taxonomy1041S0200X
Provider Legal NameLYLE G WALLACE
Location Address36 WALKER RDWest Orange, NJ 07052-4403
Mailing Address36 Walker RdWest Orange, NJ 07052-4403 · (973) 715-5591
Phone(973) 715-5591
Sole ProprietorYes
Enumeration DateMay 29, 2022
NPPES CertifiedMay 29, 2022
✔ NPI 1992444954 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtySocial Worker · SchoolBehavioral Health & Social Service Providers
Taxonomy Code1041S0200X
License✔ Licensed in NJ · 44SL04765500
36 WALKER RD, West Orange, NJ 07052
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992444954, enumerated as an "individual" on May 29, 2022.
The provider is located at 36 WALKER RD WEST ORANGE, NJ 07052 and the phone number is (973) 715-5591.
Social Worker with taxonomy code 1041S0200X and a focus in School.
