Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Summer Star Wallace

Individual provider Personal Care Attendant · NPI 1629956396

Summer Star Wallace is a Personal Care Attendant in Stout, Ohio. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

544 W Fork Rd
Stout, OH 45684-9654
Phone: (937) 421-5881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Personal Care Attendant (primary) Taxonomy 3747P1801X

Record details

NPI number1629956396
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorNo
NPI enumeratedAugust 21, 2025
Last updated in NPPESAugust 21, 2025
Certification dateAugust 21, 2025
Mailing address544 W Fork Rd, Stout, OH 45684-9654

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