Krystal Jacquelyn Wallace, MS MA BC

NPI #1295438893 in New Albany, Indiana

Provider Information

NPI Number: 1295438893
Entity Type: Individual
Name: Krystal Jacquelyn Wallace, MS MA BC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: MS MA BC
Enumeration Date: Mar 23, 2023
Last Updated: Mar 23, 2023

Practice Location

Address: 618 E MARKET ST
City: New Albany
State: Indiana
ZIP Code: 47150-2914
Phone: (502) 579-1278

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Behavior Analyst	103K00000X
Social Worker	104100000X	Primary

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