Holly Wallace, LSW

NPI #1356167563 in Normal, Illinois

Provider Information

NPI Number
1356167563
Entity Type
Individual
Name
Holly Wallace, LSW
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Social Worker
Credential
LSW
Enumeration Date
Dec 3, 2024
Last Updated
Dec 3, 2024

Practice Location

Address
1302 FRANKLIN AVE STE L500
City
Normal
ZIP Code
61761-3551
Phone
(309) 451-8888

Specialties & Taxonomy Codes

Specialty
Social Worker

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