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NPI Profile for JACKIE WALLACE in ROCHESTER, NY.
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Other Service Providers |
175T00000X |
| NPI Number | 1609751080 |
|
| Status | Active | |
| Credentials | CRPA | |
| Entity | Individual | |
| Enumeration date | 08/06/2025 | |
| Last updated | 08/06/2025 - About 10 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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JACKIE WALLACE
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JACKIE WALLACE, CRPA