Chrysanthy Wallace, LCSW-C
Social Worker, Clinical in Aberdeen, MD. Individual provider (NPI-1).
NPI number1982148185
StatusActive
Last updated in NPPESMay 8, 2019
Details
- NPI
- 1982148185
- Entity type
- Individual (NPI-1)
- Name
- Chrysanthy Wallace
- Credential
- LCSW-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 7, 2016
- Last updated
- May 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 22402 | MD | Yes |
Practice location
135 N Parke StAberdeen, MD 21001-2428
Phone 443-625-1600
Mailing address
135 N Parke StAberdeen, MD 21001-2428
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