Mr. Coleman W Wallace
Mr. Coleman W Wallace is a Pastoral Counselor in Willingboro, New Jersey. Licensed in New Jersey. Registered with an NPI since 2023.
- Licensed in
- NJ
- In the registry since
- 2023
Practice location Address checks out
15 Edge CtWillingboro, NJ 08046-2412
Phone: (609) 500-7139
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Specialties & licences
| Pastoral Counselor (primary) | Taxonomy 101YP1600X (NJ) |
|---|
Record details
| NPI number | 1720863913 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 28, 2023 |
| Last updated in NPPES | August 30, 2023 |
| Certification date | August 30, 2023 |
| Mailing address | 15 Edge Ct, Willingboro, NJ 08046-2412 |