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
Phone: (440) 998-1811
Fax: (440) 992-6828
Website:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417278995 | NPPES |
| Ohio | Other | 202127833 | TAX IDENTIFICATION |
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