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General NPI Number Information
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NPI Number | 1487467338
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Entity Type | Individual
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Provider Name | REBBIE ARPTISHA WALLACE
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 110 WALKER AVE NE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4739
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Country | US
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Telephone | 256-534-8659
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ROUND TABLE DR
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City | MADISON
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State | AL
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Zip | 35756-4292
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Country | US
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Telephone | 404-550-7671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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