Jessica Marie Wallace

NPI #1083062624 in Danvers, Massachusetts

Provider Information

NPI Number: 1083062624
Entity Type: Individual
Name: Jessica Marie Wallace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Developmental Therapist
Enumeration Date: May 24, 2016
Last Updated: May 24, 2016

Practice Location

Address: 6 SOUTHSIDE RD
City: Danvers
State: Massachusetts
ZIP Code: 01923-1409
Phone: (978) 624-3725

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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