Simone Wallace
NPI #1043906027 in Minneapolis, Minnesota
Provider Information
- NPI Number
- 1043906027
- Entity Type
- Individual
- Name
- Simone Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Apr 13, 2023
- Last Updated
- Apr 13, 2023
Practice Location
- Address
- 1044 27TH AVE SE APT D
- City
- Minneapolis
- State
- Minnesota
- ZIP Code
- 55414-2736
- Phone
- (612) 508-9723
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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