Kezia Wallerson, is a
Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities based in Montclair, New Jersey. Kezia Wallerson is licensed to practice in * (Not Available) (license number ) and her current practice location is
25 High St Apt C1, Montclair, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(315) 415-7148.
NPI number for Kezia Wallerson is 1831041730 and her current mailing address is 25 High St Apt C1, Montclair, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1831041730.
Healthcare Provider's Profile
| Full Name | Kezia Wallerson |
|---|
| Gender | Female |
|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|
| Location | 25 High St Apt C1, Montclair, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1831041730
- Provider Enumeration Date: 02/12/2026
- Last Update Date: 02/12/2026
Medical Identifiers
Medical identifiers for Kezia Wallerson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831041730 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Secondary |
| 133NN1002X | Nutritionist - Nutrition, Education | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Secondary |
| 174H00000X | Health Educator | (* (Not Available)) | Secondary |
| 320900000X | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | (* (Not Available)) | 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. Kezia Wallerson 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 |
|---|
Kezia Wallerson,
25 High St Apt C1,
Montclair, NJ 07042-2452
Ph: (315) 415-7148 | Kezia Wallerson,
25 High St Apt C1,
Montclair, NJ 07042-2452
Ph: (315) 415-7148 |
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