Wallace, Jennifer M.

Wallace, Jennifer M. is an individual health care provider with primary practice located at 2298 W Horizon Ridge Pkwy Suite 109, Henderson NV 89052-2696. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wallace, Jennifer M. can be contacted via phone (702) 363-7284.

Contact Information

Primary practice address
2298 W Horizon Ridge Pkwy Suite 109 Henderson NV 89052-2696
Phone: (702) 363-7284
Fax: (702) 242-5252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1118L Nevada
Behavioral Health & Social Service Providers / Social Worker 104100000X 00561-A Nevada
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X R05387 Nevada

Profile Details

NPI number 1093927907
LBN Legal business name Wallace, Jennifer M.
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2007
Last updated Jul 8th, 2007 - about 17 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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