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1255996617
JENNIFER LYNN HATAWAY-WALLACE
FORT MEADE, SD
NPI
1255996617
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: SD 3589)
Enumeration Date
2019-05-01
Last Update Date
2019-05-01
Business Address
JENNIFER LYNN HATAWAY-WALLACE LCSW
113 COMANCHE RD
FORT MEADE, SD 57741-1002
Phone number: 605-720-7422
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Mailing Address
JENNIFER LYNN HATAWAY-WALLACE LCSW
113 COMANCHE RD
FORT MEADE, SD 57741-1002
Phone number: 605-720-7422
Copy
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