Mary D Wallace is a Clinical in Syracuse, New York. Mary D Wallace practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary D Wallace is 1619045648. The last update date is 2007-07-08.
Mary D Wallace's current location address is 105 Broadview Dr, Syracuse, New York. You can contact this provider via phone number 3154751297. The mailing address for Mary D Wallace is 105 Broadview Dr, Syracuse, New York. To know further, please read the information below!
Provider Profile Detail
Provider Name | Mary D Wallace |
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Address | 105 Broadview Dr, Syracuse, New York |
Phone Number | 3154751297 |
Fax Number | |
Sole Proprietor | Y |
Credentials | L.C.S.W.R. |
NPI Number Detail
NPI Number | 1619045648 |
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Provider Enumeration Date | 2006-11-30 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 105 Broadview Dr |
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City | Syracuse |
State | New York (NY) |
Post Code | 132151505 |
Phone Number | 3154751297 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | R014836-1 |
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identification code assigned to Mary D Wallace by the Centers for Medicare & Medicaid Services?
The Mary D Wallace has been issued the NPI (National Provider Identifier) 1619045648. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Mary D Wallace located?
The Mary D Wallace is located at 105 Broadview Dr, Syracuse, NY 132151505.
What is Mary D Wallace's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Mary D Wallace is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1619045648 to Mary D Wallace?
The Centers for Medicare & Medicaid Services originally issued the 1619045648 to Mary D Wallace on 2006-11-30.
When was the information regarding Mary D Wallace most recently updated?
The details pertaining to the Mary D Wallace, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.