Search › Illinois › 101YP2500X
Kathi Wallace, L.C.P.C
NPI 1114319092 · on the registry since 2015 · sole proprietor
Practice
- Address
- 5 Schiber Ct Ste D
Maryville, IL 62062 - Phone
- (314) 626-4285
Additional practice sites
- 301 Sovereign Ct Ste 211, Ballwin, MO
Registry record
- Primary taxonomy
- 101YP2500X
101YP2500X
- Also registered as
- 101YP2500X
101YP2500X - Licence states on file
- MO, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-02-02
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 Illinois