Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KATHLEEN M. WALLACE, PSY.D
Active Sole ProprietorDR. KATHLEEN M. WALLACE, PSY.D is a Clinical Psychologist healthcare provider located in VIENNA,, Ohio. NPI 1770636367 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · VIENNA,, OH
Registration Details
- NPI Number
- 1770636367
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 19, 2007 (19.560798379531 yrs)
- Last Updated
- Sep 15, 2025
- Licenses
-
PS015630 (PA)4820 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3400 WARREN-SHARON ROADVIENNA,, OH, 444739532Browse OH providers · Browse ZIP 44473
- Phone
- 3307205786
- Primary Specialty
-
Clinical Psychologist
103TC0700X
- Additional Specialty
- Clinical Psychologist
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.