Search › New Jersey › 104100000X
Kevin Wallace, LMSW
NPI 1073207049 · on the registry since 2023
Practice
- Address
- 799 John St
Teaneck, NJ 07666 - Phone
- (917) 327-7162
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-06-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey