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

Elizabeth Denise Wallace

Individual provider Case Management Agency · NPI 1205680014

Elizabeth Denise Wallace is a Case Management Agency in Vidalia, Georgia. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

210 N Smalley Dr
Vidalia, GA 30474-6105
Phone: (140) 445-1289
Show map & directions

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

Specialties & licences

Case Management Agency (primary) Taxonomy 251B00000X

Record details

NPI number1205680014
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 16, 2024
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

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