Joanna Wallace
NPI #1760989537 in Gaston, South Carolina
Provider Information
- NPI Number
- 1760989537
- Entity Type
- Individual
- Name
- Joanna Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Apr 9, 2018
- Last Updated
- Apr 15, 2018
Practice Location
- Address
- 241 WOODCOTE DR
- City
- Gaston
- State
- South Carolina
- ZIP Code
- 29053-8479
- Phone
- (803) 397-6902
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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