Mr. Corey Wallace
Mr. Corey Wallace is a Child Intellectual and/or Developmental Disabilities Respite Care in Canton, Ohio. Practices as a sole proprietor. Licensed in Ohio.
- Licensed in
- OH
- In the registry since
- 2023
Practice location Address checks out
2460 25th St NECanton, OH 44705-2468
Phone: (330) 704-0134
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Specialties & licences
| Child Intellectual and/or Developmental Disabilities Respite Care (primary) | Taxonomy 385HR2060X (OH) |
|---|
Record details
| NPI number | 1356027999 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 27, 2023 |
| Last updated in NPPES | June 27, 2023 |
| Certification date | June 27, 2023 |
| Mailing address | 2460 25th St Ne, Canton, OH 44705-2468 |
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