Wallace, Chantel Lee

Wallace, Chantel Lee is an sole proprietor health care provider with primary practice located at 581 N Ash St , Blackfoot ID 83221-2223. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wallace, Chantel Lee can be contacted via phone (208) 973-5077.

Contact Information

Primary practice address
581 N Ash St Blackfoot ID 83221-2223
Phone: (208) 973-5077
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LMSW-43731 Idaho

Profile Details

NPI number 1669234308
LBN Legal business name Wallace, Chantel Lee
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2024
Last updated Jan 29th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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