NPI 1245124270

Melissa Marie Wallace

Practitioner Foster Care Agency Yuma, AZ

Practice location

Address: 2797 W 21st Ln, Yuma, AZ 85364-6059
Phone: (928) 386-0844

Registered specialties (2)

Foster Care Agency Primary

Agencies Taxonomy 253J00000X Licence 780 (AZ)

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Child Physical Disabilities Respite Care

Respite Care Facility Taxonomy 385HR2065X Licence 780 (AZ)

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Registry record

NPI: 1245124270
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jun 2025
Record last updated: 4 Jun 2025

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.