| Jennifer Wallace, | |
| 
					4226 Green Lake Rd, West Bloomfield, MI 48323-1139  | |
| (248) 404-5616 | |
| Not Available | 
| Full Name | Jennifer Wallace | 
|---|---|
| Gender | Female | 
| Speciality | Psychologist | 
| Location | 4226 Green Lake Rd, West Bloomfield, Michigan | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1295083897 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 103T00000X | Psychologist | 6301014813 (Michigan) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jennifer Wallace, 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 Ph: (248) 404-5616  | Jennifer Wallace, 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 Ph: (248) 404-5616  | 
Ms. Karen Bango, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6555 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-592-2654 Fax: 248-592-2660  | |
Daniel Simmons, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6555 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-592-2300 Fax: 248-592-2340  | |
Emma Fay Kelly, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7035 Orchard Lake Rd Ste 800, West Bloomfield, MI 48322 Phone: 248-669-9500  | |
Mrs. Joan Frances Lazar, MA, LLP, LPC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6024 W Maple Rd, Suite 107, West Bloomfield, MI 48322 Phone: 248-489-1550 Fax: 248-489-9767  | |
Dr. Katherine Ann Young, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1943 Windside, West Bloomfield, MI 48324 Phone: 248-681-5829  | |
Kimberly Elizabeth Zuteck,  Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5757 W Maple Rd Ste 800b, West Bloomfield, MI 48322 Phone: 586-574-5845  | |
Dr. Alicia Ellen Tisdale, PHD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 5101 Willow Pond Drive, West Bloomfield, MI 48323 Phone: 248-974-1783  |