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Asha Lee Wallace
Student in an Organized Health Care Education/Training Program in Bolingbrook, Illinois
NPI 1497213789

Asha Lee Wallace is a Student in an Organized Health Care Education/Training Program based in Bolingbrook, IL. Asha Lee Wallace practices in Bolingbrook, IL. The NPI Number for Asha Lee Wallace is 1497213789 and holds a License No. (Illinois).

The current practice location address for Asha Lee Wallace is 9 Firethorn Ct, Bolingbrook, IL and can be reached out via phone at 630-923-9516.

Location: 9 Firethorn Ct, Bolingbrook, IL, 60490-2003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497213789
Provider Name
Asha Lee Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
9 Firethorn Ct, Bolingbrook, IL, 60490-2003
Phone Number
630-923-9516
Fax Number
Provider Enumeration Date
03/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9 Firethorn Ct
City
Bolingbrook
State
Illinois
Zip
60490-2003
Phone Number
630-923-9516
Fax Number
person
Provider Business Mailing Address Details
Address
9 Firethorn Ct
City
Bolingbrook
State
Illinois
Zip
60490-2003
Phone Number
630-923-9516
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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