Jill Wallace
Jill Wallace is an Addiction (Substance Use Disorder) Counselor in Wauwatosa, Wisconsin. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
- Specialties on file
- 3
Practice location Address checks out
2600 N Mayfair Rd Ste 400Wauwatosa, WI 53226-1306
Phone: (414) 933-9390
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Specialties & licences
| Professional Counselor (primary) | Taxonomy 101YP2500X |
|---|---|
| Addiction (Substance Use Disorder) Counselor | Taxonomy 101YA0400X |
| Poetry Therapist | Taxonomy 102X00000X |
Record details
| NPI number | 1871240978 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 8, 2022 |
| Last updated in NPPES | March 8, 2022 |
| Certification date | March 7, 2022 |
| Mailing address | 2600 N Mayfair Rd Ste 400, Wauwatosa, WI 53226-1306 |
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