Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dashiya Wallace

Individual provider Clinical Social Worker · NPI 1073191557

Dashiya Wallace is a Clinical Social Worker in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2021.

Licensed in
PA
In the registry since
2021

Practice location Address checks out

4812 Baltimore Ave
Philadelphia, PA 19143-3419
Phone: (215) 563-7863
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW136536 (PA)

Record details

NPI number1073191557
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 29, 2021
Last updated in NPPESMarch 29, 2021
Certification dateMarch 29, 2021

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