Cynthia Wallace, LICSW
NPI #1093075913 in Walla Walla, Washington
Provider Information
- NPI Number
- 1093075913
- Entity Type
- Individual
- Name
- Cynthia Wallace, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- May 24, 2012
- Last Updated
- May 24, 2012
Practice Location
- Address
- 19 E BIRCH ST STE 103
- City
- Walla Walla
- State
- Washington
- ZIP Code
- 99362-3084
- Phone
- (509) 200-7290
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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