MRS. Colleen Carver Wallace, MS

NPI #1720289580 in Urbana, Ohio

Provider Information

NPI Number: 1720289580
Entity Type: Individual
Name: MRS. Colleen Carver Wallace, MS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: MS
Enumeration Date: May 30, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1150 SCIOTO ST
City: Urbana
State: Ohio
ZIP Code: 43078-2289
Phone: (937) 652-4555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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