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Mrs. Gennifer Wallace, MA
Addiction (Substance Use Disorder) Counselor in Charlestown, Indiana
NPI 1598124992

Gennifer Wallace is an Addiction (Substance Use Disorder) Counselor based in Charlestown, IN and is specialized in Addiction (Substance Use Disorder). Gennifer Wallace practices in Charlestown, IN and has the professional credentials of MA. The NPI Number for Gennifer Wallace is 1598124992 and holds a License No. (Indiana).

The current practice location address for Gennifer Wallace is 7509 Charlestown Pike, Charlestown, IN and can be reached out via phone at 812-256-4686 and via fax at 812-256-4415.

Location: 7509 Charlestown Pike, Charlestown, IN, 47111-9623
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598124992
Provider Name
Gennifer Wallace
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
7509 Charlestown Pike, Charlestown, IN, 47111-9623
Phone Number
812-256-4686
Fax Number
812-256-4415
Provider Enumeration Date
02/15/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
7509 Charlestown Pike
City
Charlestown
State
Indiana
Zip
47111-9623
Phone Number
812-256-4686
Fax Number
812-256-4415
person
Provider Business Mailing Address Details
Address
7509 Charlestown Pike
City
Charlestown
State
Indiana
Zip
47111-9623
Phone Number
812-256-4686
Fax Number
812-256-4415
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
(Indiana)
Definition
Definition to come...
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