Wallace, Juanita

Wallace, Juanita is an sole proprietor health care provider with primary practice located at 570 Shackelford Rd , Florissant MO 63031-5457. 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, Juanita can be contacted via phone (314) 583-0549.

Contact Information

Primary practice address
570 Shackelford Rd Florissant MO 63031-5457
Phone: (314) 583-0549
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2002006418 Missouri

Profile Details

NPI number 1326164278
LBN Legal business name Wallace, Juanita
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2007
Last updated Jul 9th, 2007 - about 18 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.

Request for update

Popular Providers