Ebonie Wallace
Ebonie Wallace is a Case Manager/Care Coordinator in Daytona Beach, Florida. Registered with an NPI since 2016.
- In the registry since
- 2016
Practice location Address checks out
140 S Beach St Ste 310Daytona Beach, FL 32114-4409
Phone: (386) 898-6040
Fax: (386) 256-2320
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Specialties & licences
| Case Manager/Care Coordinator (primary) | Taxonomy 171M00000X |
|---|
Record details
| NPI number | 1871044255 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | October 20, 2016 |
| Last updated in NPPES | February 18, 2021 |
| Certification date | February 18, 2021 |
| Mailing address | 140 S Beach St, Daytona Beach, FL 32114-4472 |
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