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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. BROOKE MARY WALLACE, LCSW, BCD

Active Sole Proprietor

MRS. BROOKE MARY WALLACE, LCSW, BCD is a Clinical Social Worker healthcare provider located in LACKLAND A F B, Texas. NPI 1730228057 is currently active in the NPPES registry. Verify at CMS.

Clinical Social Worker · LACKLAND A F B, TX

Registration Details

NPI Number
1730228057
Provider Type
Individual
Gender
Female
NPI Issued
Feb 5, 2007 (19.480783812058 yrs)
Last Updated
Apr 17, 2018
License
51643 (TX)
Sole Proprietor
Yes

Practice Information

Address
2200 BERGQUIST DR
SUITE 1
LACKLAND A F B, TX, 782369907
Browse TX providers · Browse ZIP 78236
Phone
2105089058
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in LACKLAND A F B, TX

Name Credential NPI
CHARLES EDWIN HULSHOF LCSW 1396723763
CHRISTOPHER D. CLINE LCSW 1467424127
MS. EVELYN PAULMA LAUREL LMSW 1932110244
MS. MELENA K. HEWITT MSW, LCSW 1003928458
KIRSTEN HARDY LCSW 1770683039
BARBARA E. SEVERSON-OLSON LCSW, BCD 1770638231
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.