Ms Katherine Sue Wallace, MS is a
Counselor - Addiction (substance Use Disorder) based in Gideon, Missouri. Ms Katherine Sue Wallace is licensed to practice in Missouri (license number 6385) and her current practice location is
408 S Gideon Ave, Gideon, Missouri. She can be reached at her office (for appointments etc.) via phone at
(573) 370-2129.
NPI number for Ms Katherine Sue Wallace is 1942583893 and her current mailing address is 408 S Gideon Ave, Gideon, Missouri. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1942583893.
Healthcare Provider's Profile
| Full Name | Ms Katherine Sue Wallace |
|---|
| Gender | Female |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 408 S Gideon Ave, Gideon, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1942583893
- Provider Enumeration Date: 09/27/2011
- Last Update Date: 09/27/2011
Medical Identifiers
Medical identifiers for Ms Katherine Sue Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942583893 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 6385 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Katherine Sue Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Katherine Sue Wallace, MS
408 S Gideon Ave,
Gideon, MO 63848-9200
Ph: (573) 370-2129 | Ms Katherine Sue Wallace, MS
408 S Gideon Ave,
Gideon, MO 63848-9200
Ph: (573) 370-2129 |
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