Kellie Wallace, M.S.
Counselor, Mental Health in Salem, MA. Individual provider (NPI-1).
NPI number1508148305
StatusActive
Last updated in NPPESSep 16, 2011
Details
- NPI
- 1508148305
- Entity type
- Individual (NPI-1)
- Name
- Kellie Wallace
- Credential
- M.S.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 16, 2011
- Last updated
- Sep 16, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
35 Congress StSuite 214
Salem, MA 01970-5529
Phone 508-932-9235
Mailing address
35 Congress StreetSuite 214
Salem, MA 01970
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