Wallace, Jennifer Dawn

Wallace, Jennifer Dawn is an individual health care provider with primary practice located at 204 Bevins Ln Ste A , Georgetown KY 40324-6145. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Wallace, Jennifer Dawn can be contacted via phone (859) 951-9777.

Contact Information

Primary practice address
204 Bevins Ln Ste A Georgetown KY 40324-6145
Phone: (859) 951-9777
Fax: (859) 951-9779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 104157
Behavioral Health & Social Service Providers / Counselor 101Y00000X 104157 Kentucky

Profile Details

NPI number 1174158976
LBN Legal business name Wallace, Jennifer Dawn
Credentials LPCC/S
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2020
Last updated Nov 20th, 2020 - about 4 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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