| NPI | 1124388418 |
|---|---|
| Former Name | KARA WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-07-02 |