person
Mr. Kelly Wallace
Mental Health Counselor in Philadelphia, Pennsylvania
NPI 1427726793

Kelly Wallace is a Mental Health Counselor based in Philadelphia, PA and is specialized in Mental Health. Kelly Wallace practices in Philadelphia, PA. The NPI Number for Kelly Wallace is 1427726793 and holds a License No. (Pennsylvania).

The current practice location address for Kelly Wallace is 1348 Bainbridge St, Philadelphia, PA and can be reached out via phone at 215-563-0652.

Location: 1348 Bainbridge St, Philadelphia, PA, 19147-1810
person
Provider Profile Details
NPI Number
1427726793
Provider Name
Kelly Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
1348 Bainbridge St, Philadelphia, PA, 19147-1810
Phone Number
215-563-0652
Fax Number
Provider Enumeration Date
09/01/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1348 Bainbridge St
City
State
Zip
19147-1810
Phone Number
215-563-0652
Fax Number
person
Provider Business Mailing Address Details
Address
1348 Bainbridge St
City
State
Zip
19147-1810
Phone Number
215-563-0652
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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