Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ELIZABETH DENISE WALLACE
Active Sole ProprietorELIZABETH DENISE WALLACE is a Case Management Agency healthcare provider located in VIDALIA, Georgia. NPI 1205680014 is currently active in the NPPES registry. Verify at CMS.
Case Management Agency · VIDALIA, GA
Registration Details
- NPI Number
- 1205680014
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 16, 2024 (2.3609334611806 yrs)
- Last Updated
- Apr 16, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
210 N SMALLEY DRVIDALIA, GA, 304746105Browse GA providers · Browse ZIP 30474
- Phone
- 1404451289
- Primary Specialty
-
Case Management Agency
251B00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.