Wallace, Icelinn Perdue
Wallace, Icelinn Perdue is an individual health care provider with primary practice located at 70 Lafayette St , Pontiac MI 48342-2033. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Wallace, Icelinn Perdue can be contacted via phone (248) 338-7458.Contact Information
Primary practice address
70 Lafayette St
Pontiac MI 48342-2033
Phone: (248) 338-7458
Fax: (248) 338-7513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 680109826 | Michigan |
Profile Details
| NPI number | 1376778100 |
|---|---|
| LBN Legal business name | Wallace, Icelinn Perdue |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2009 |
| Last updated | May 22nd, 2009 - about 15 years ago |
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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