Kelly M Wallace
Kelly M Wallace is a Mental Health Counselor in East Longmeadow, Massachusetts. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
41 Birchland AveEast Longmeadow, MA 01028-2411
Phone: (141) 388-7495
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1871225706 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | June 29, 2022 |
| Last updated in NPPES | June 29, 2022 |
| Certification date | June 29, 2022 |
| Mailing address | 41 Birchland Ave, East Longmeadow, MA 01028-2411 |
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