NICOLE M. WALLACE

HUNTINGTON, NY
NPI1275821993
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NY  084663)
Additional Taxonomies104100000X Social Worker
(Licence: NY  084063)
Enumeration Date2011-07-15
Last Update Date2018-03-17
Business Address
-- NICOLE M. WALLACE MSW, LCSW
177 MAIN ST STE 206
HUNTINGTON, NY 11743-6917
Phone number: 631-380-3454
Mailing Address
-- NICOLE M. WALLACE MSW, LCSW
177 MAIN ST STE 206
HUNTINGTON, NY 11743-6917
Phone number: