Shatavea Wallace
NPI #1144196833 in Glassboro, New Jersey
Provider Information
- NPI Number
- 1144196833
- Entity Type
- Individual
- Name
- Shatavea Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Oct 11, 2025
- Last Updated
- Oct 11, 2025
Practice Location
- Address
- 42 DELSEA DR S
- City
- Glassboro
- State
- New Jersey
- ZIP Code
- 08028-2621
- Phone
- (844) 422-3632
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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