Jenna Wallace, LCAT
Jenna Wallace, LCAT is an Undefined Non-Physician Type (Specify) in New City, New York. Qualified in 2021, 5 years ago. Licensed in New York.
- Years since qualifying
- 5
- Licensed in
- NY
- In the registry since
- 2024
Practice location Address checks out
66 Pine StNew City, NY 10956-6236
Phone: (914) 348-3040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Music Therapist (primary) | Taxonomy 225A00000X · Licence 002925 (NY) |
|---|
Record details
| NPI number | 1558101063 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | LCAT |
| Sole proprietor | No |
| NPI enumerated | May 31, 2024 |
| Last updated in NPPES | May 31, 2024 |
| Certification date | May 31, 2024 |
| Mailing address | 66 Pine St, New City, NY 10956-6236 |
Medicare enrollment
| Medicare specialty | UNDEFINED NON-PHYSICIAN TYPE (SPECIFY) |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |