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Jill Wallace, M.Ed,LCPC

Counselor, Professional in Topsham, ME. Individual provider (NPI-1).

NPI number1992029664
StatusActive
Last updated in NPPESMar 24, 2010

Details

NPI
1992029664
Entity type
Individual (NPI-1)
Name
Jill Wallace
Credential
M.Ed,LCPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 24, 2010
Last updated
Mar 24, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, ProfessionalCC00000733MEYes

Practice location

56 Elm St
Topsham, ME 04086-1417

Phone 207-449-5729 · Fax 866-531-8540

Mailing address

56 Elm St
Topsham, ME 04086-1417

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