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NPI Profile for LAUREL L WALLACE in ENTERPRISE, OR.
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 | |||
Case Manager/Care Coordinator |
171M00000X |
| NPI # | 1881337319 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/13/2022 | |
| Last updated | 08/08/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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LAUREL L WALLACE
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LAUREL L WALLACE