Alisa D Wallace
Case Manager/Care Coordinator in Monticello, KY. Individual provider (NPI-1).
NPI number1669936621
StatusActive
Last updated in NPPESJan 24, 2019
Details
- NPI
- 1669936621
- Entity type
- Individual (NPI-1)
- Name
- Alisa D Wallace
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 24, 2019
- Last updated
- Jan 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
803 Columbia AveMonticello, KY 42633
Phone 606-348-9318
Mailing address
130 Southern School RdSomerset, KY 42501-3223
Phone 606-679-4782
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All 17 Case Manager/Care Coordinator providers in Monticello · All 268 providers in Monticello
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