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1487470795
JAKEYLA WALLACE
CONCORD, NC
NPI
1487470795
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2024-12-02
Last Update Date
2024-12-02
Business Address
JAKEYLA WALLACE
920 CHURCH ST N
CONCORD, NC 28025-2927
Phone number: 704-403-4004
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Mailing Address
JAKEYLA WALLACE
6218 GINKGO LN
CHARLOTTE, NC 28215-7146
Phone number: 707-707-7372
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