Kati Wallace
Social Worker, Clinical in Cloverdale, IN. Individual provider (NPI-1).
NPI number1245072073
StatusActive
Last updated in NPPESOct 3, 2025
Details
- NPI
- 1245072073
- Entity type
- Individual (NPI-1)
- Name
- Kati Wallace
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2024
- Certification date
- Oct 3, 2025
- Last updated
- Oct 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34010387A | IN | Yes |
Practice location
3 W Boone StCloverdale, IN 46120-9003
Phone 812-605-9748
Mailing address
3 W Boone StCloverdale, IN 46120-9003
Phone 812-605-9748
Other practice locations
1542 S Bloomington St
Greencastle, IN 46135-2297
Greencastle, IN 46135-2297
Phone 765-301-7300 · Fax 765-301-7491
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