Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GLEN KNIGHT WALLACE, ED.D
ActiveGLEN KNIGHT WALLACE, ED.D is a Professional Counselor healthcare provider located in OKALHOMA CITY, Oklahoma. NPI 1548493091 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · OKALHOMA CITY, OK
Registration Details
- NPI Number
- 1548493091
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 1, 2009 (16.920330096887 yrs)
- Last Updated
- Sep 1, 2009
- Licenses
-
535 (OK)333 (OK)
Practice Information
- Address
-
7932 NICHOLSONOKALHOMA CITY, OK, 73162Browse OK providers · Browse ZIP 73162
- Phone
- 4057281173
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Marriage & Family Therapist
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.