Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JESSICA LYNN WALLACE
Active Sole ProprietorJESSICA LYNN WALLACE is a Community/Behavioral Health healthcare provider located in MUSE, Oklahoma. NPI 1659637478 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · MUSE, OK
Registration Details
- NPI Number
- 1659637478
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 5, 2012 (14.355517940258 yrs)
- Last Updated
- Apr 5, 2012
- Sole Proprietor
- Yes
Practice Information
- Address
-
26652 MUSE ROADMUSE, OK, 74949Browse OK providers · Browse ZIP 74949
- Phone
- 9185671719
- Primary Specialty
-
Community/Behavioral Health
251S00000X
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.