Codie Wallace, MSW

NPI #1073759429 in Casper, Wyoming

Provider Information

NPI Number
1073759429
Entity Type
Individual
Name
Codie Wallace, MSW
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Social Worker - Clinical
Credential
MSW
Enumeration Date
Jan 6, 2009
Last Updated
Sep 21, 2012

Practice Location

Address
2510 E 15TH ST
Address 2
SUITE 11
City
Casper
State
Wyoming
ZIP Code
82609-4111
Phone
(307) 234-9979

Specialties & Taxonomy Codes

Specialty
Case Manager/Care Coordinator
Social Worker - ClinicalClinical

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