| Kristin Wallace, | |
|
940 Ebenezer Blvd, Madison, MS 39110-6002 | |
| (601) 790-0583 | |
| Not Available |
| Full Name | Kristin Wallace |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 940 Ebenezer Blvd, Madison, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154931129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | M8300 (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Wallace, 437 Pin Oak Dr, Madison, MS 39110-9365 Ph: () - | Kristin Wallace, 940 Ebenezer Blvd, Madison, MS 39110-6002 Ph: (601) 790-0583 |
Ms. Brenda B Donald, LCSW, BCD Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 133 Executive Dr, Suite B, Madison, MS 39110 Phone: 601-898-7778 | |
Pamela D Stalder, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299 | |
Cheri L Nyegaard Holbrook, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299 | |
Fred Rickman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299 | |
Melinda Edwards, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299 | |
Melanie L Moreau, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 254 Ingleside Dr, Madison, MS 39110 Phone: 601-695-1919 Fax: 601-420-5299 |