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Jennifer Wallace
NPI 1295083897 · on the registry since 2012
Practice
- Address
- 4226 Green Lake Rd
West Bloomfield, MI 48323 - Phone
- (248) 404-5616
Registry record
- Primary taxonomy
- Psychologist
103T00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-08-29
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 Michigan