Lisa M Wallace in Fort Collins - Professional
Lisa M Wallace - NPI 1124002571
Lisa M Wallace is a Professional in Fort Collins, Colorado. Lisa M Wallace practices all healthcare services and medical treatments related to Professional. The NPI Number for Lisa M Wallace is 1124002571. The last update date is 2021-03-15.
Lisa M Wallace's current location address is Po Box 273338, Fort Collins, Colorado. You can contact this provider via phone number 9708174049 and fax number 8778334460. The mailing address for Lisa M Wallace is Po Box 273338, Fort Collins, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lisa M Wallace |
|---|---|
| Address | Po Box 273338, Fort Collins, Colorado |
| Phone Number | 9708174049 |
| Fax Number | 8778334460 |
| Sole Proprietor | N |
| Credentials | MA, LPC |
NPI Number Detail
| NPI Number | 1124002571 |
|---|---|
| Provider Enumeration Date | 2005-11-30 |
| Last Updated Date | 2021-03-15 |
Provider Mailing Address Detail
| Address | Po Box 273338 |
|---|---|
| City | Fort Collins |
| State | Colorado (CO) |
| Post Code | 805273338 |
| Phone Number | 9708174049 |
| Fax Number | 8778334460 |
Provider's Primary Taxonomy Detail
| Speciality | Professional |
|---|---|
| Taxonomy | 101Yp2500X |
| Licence No | 5913 |
|
Definition: A general counselor who helps people with personal, social, educational, and career issues. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 312410 | WY | BS OF WY |
Post Comment/ Review Below
What is the unique provider identifier assigned to Lisa M Wallace?
The Lisa M Wallace has been issued the NPI (National Provider Identifier) 1124002571 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Lisa M Wallace is physically located?
The Lisa M Wallace is physically situated at the following address: Po Box 273338, Fort Collins, CO, 805273338.
What is Lisa M Wallace's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Lisa M Wallace is Professional, and the taxonomy code that categorizes this field of expertise is 101Yp2500X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1124002571 to Lisa M Wallace?
The Centers for Medicare & Medicaid Services originally issued the 1124002571 to Lisa M Wallace on 2005-11-30.
As of what date were the details pertaining to Lisa M Wallace last refreshed?
The information related to the Lisa M Wallace, including its address, specialty, and other relevant details, was last updated on 2021-03-15.
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