Janise Wallace, LCSW

NPI #1396348603 in Ludowici, Georgia

Provider Information

NPI Number: 1396348603
Entity Type: Individual
Name: Janise Wallace, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Nov 18, 2020
Last Updated: Nov 18, 2020

Practice Location

Address: 83 HOFFER LN SE
City: Ludowici
State: Georgia
ZIP Code: 31316
Phone: (254) 238-9473

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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