Wallace, Sara Jane

Wallace, Sara Jane is an sole proprietor health care provider with primary practice located at 6407 Austinburg Rd , Ashtabula OH 44004-9306. 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, Sara Jane can be contacted via phone (440) 998-1811.

Contact Information

Primary practice address
6407 Austinburg Rd Ashtabula OH 44004-9306
Fax: (440) 992-6828
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X I 0005152 Ohio

Profile Details

NPI number 1417278995
LBN Legal business name Wallace, Sara Jane
Credentials LISW-S
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2010
Last updated Jun 18th, 2010 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1417278995 NPPES
Ohio Other 202127833 TAX IDENTIFICATION

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