Elizabeth Denise Wallace

NPI #1205680014 in Vidalia, Georgia

Provider Information

NPI Number: 1205680014
Entity Type: Individual
Name: Elizabeth Denise Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Management
Enumeration Date: Apr 16, 2024
Last Updated: Apr 16, 2024

Practice Location

Address: 210 N SMALLEY DR
City: Vidalia
State: Georgia
ZIP Code: 30474-6105
Phone: (140) 445-1289

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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