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Kenneth Wallace, PSY.D

NPI 1417135815 · on the registry since 2008 · sole proprietor

Practice

Address
3400 Warren-Sharon Road
Vienna, OH 44473
Phone
(330) 720-5768

Registry record

Primary taxonomy
103TC0700X
103TC0700X
Also registered as
103TC0700X
Licence states on file
PA, OH
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2008-02-07

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 Ohio