Search › Illinois › 1041C0700X
Camilla Wallace, LCSW
NPI 1851572606 · on the registry since 2007
Practice
- Address
- 1007 Church St
Suite 302
Evanston, IL 60201 - Phone
- (847) 492-1938
- Fax
- (847) 423-5670
- Organisation at this address
- Self Design, Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 32
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- IL, MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-09-16
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