NPI 1003064213

Jennifer Wallace, LCSW

Practitioner Clinical Social Worker Greeley, CO

Practice location

Address: 1300 N 17th Ave, Greeley, CO 80631-9584
Phone: (970) 347-2120

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence CSW.00001141 (CO)

Other Social Worker providers in Colorado →

Registry record

NPI: 1003064213
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Aug 2008
Record last updated: 9 Sep 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.