Wallace, Terry Eugene
Wallace, Terry Eugene is an sole proprietor health care provider with primary practice located at 104 Ne Avenue A , Idabel OK 74745. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wallace, Terry Eugene can be contacted via phone (580) 286-3301.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 71 | Oklahoma |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 9591601399 | Oklahoma |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 558 | Oklahoma |
Profile Details
| NPI number | 1831304922 |
|---|---|
| LBN Legal business name | Wallace, Terry Eugene |
| Credentials | CADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2007 |
| Last updated | Jul 8th, 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.
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