Kelley Wallace, LICSW
NPI #1750448833 in Walpole, Massachusetts
Provider Information
- NPI Number
- 1750448833
- Entity Type
- Individual
- Name
- Kelley Wallace, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Jan 2, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 399 LINCOLN RD
- City
- Walpole
- State
- Massachusetts
- ZIP Code
- 02081-1218
- Phone
- (508) 668-7703
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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