Icelinn Perdue Wallace
Icelinn Perdue Wallace is a Social Worker in Pontiac, Michigan. Licensed in Michigan. Registered with an NPI since 2009.
- Licensed in
- MI
- In the registry since
- 2009
Practice location Address checks out
70 Lafayette StPontiac, MI 48342-2033
Phone: (248) 338-7458
Fax: (248) 338-7513
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Social Worker (primary) | Taxonomy 104100000X · Licence 680109826 (MI) |
|---|
Record details
| NPI number | 1376778100 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | May 22, 2009 |
| Last updated in NPPES | May 22, 2009 |
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