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Rachel Ann Wallace, BA,CDPT
Addiction (Substance Use Disorder) Counselor in Kelso, Washington
NPI 1568989788

Rachel Ann Wallace is an Addiction (Substance Use Disorder) Counselor based in Longview, WA and is specialized in Addiction (Substance Use Disorder). Rachel Ann Wallace practices in Kelso, WA and has the professional credentials of BA,CDPT. The NPI Number for Rachel Ann Wallace is 1568989788 and holds a License No. 60336482 (Washington).

The current practice location address for Rachel Ann Wallace is 210 Pacific Ave N, Kelso, WA and can be reached out via phone at 360-423-0203 and via fax at 360-577-0269.

Location: 210 Pacific Ave N, Kelso, WA, 98632-8140
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568989788
Provider Name
Rachel Ann Wallace
Credential
BA,CDPT
Provider Entity Type
Individual
Gender
Female
Address
210 Pacific Ave N, Kelso, WA, 98632-8140
Phone Number
360-423-0203
Fax Number
360-577-0269
Provider Enumeration Date
08/28/2017
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
2101606 05 WA
institution
Provider Business Practice Location Address Details
Address
210 Pacific Ave N
City
Kelso
State
Washington
Zip
98626-3414
Phone Number
360-423-0203
Fax Number
360-577-0269
person
Provider Business Mailing Address Details
Address
210 Pacific Ave N
City
Kelso
State
Washington
Zip
98626-3414
Phone Number
360-423-0203
Fax Number
360-577-0269
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
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Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
60336482 (Washington)
Definition
Definition to come...
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