KENNETH RALPH WALLACE II (NPI# 1417135815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417135815 |
| Entity Type | Individual |
| Full Name | KENNETH RALPH WALLACE II |
| Credential | PSY.D. |
| Practice Address |
3400 Warren-sharon Road Vienna OH 44473-9532 |
| Practice Telephone | 3307205768 |
| Mailing Telephone | 3307205768 |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-02-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
4838 | OH | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PS015513 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346548708 | Kenneth Mark Wallace Jr. | Massage Therapist | 4004 89th Ave Se, Mercer Island, WA 98040-4102 | 2011-03-09 |
| 1942342548 | Kenneth F Wallace | Dentist | 280 Mt Zion Rd, Suite D, Florence, KY 41042 | 2007-02-12 |
| 1053428680 | Kenneth Lee Wallace | Dentist | 4226 Little Rd, Arlington, TX 76016-5601 | 2006-08-23 |
| 1295791754 | Kenneth A Wallace IIi | Dermatology | 1091 Se 59th St, Ocala, FL 34480-6146 | 2006-04-25 |
| 1952787533 | Kenneth Wallace | Physical Therapy Assistant | 170 Corey Rd, Brighton House Rehabilitation and Nursing Center, Brighton, MA 02135 | 2015-08-05 |
| 1952706673 | Kenneth Wallace | Chiropractor | 119 S Park Ave, Titusville, FL 32796-3377 | 2014-10-23 |
| 1598737405 | Kenneth K Wallace | Specialist | 3000 Rogers Ave, Fort Smith, AR 72901-4232 | 2006-02-03 |
| Street Address |
3400 WARREN-SHARON ROAD |
| City | VIENNA |
| State | OH |
| Zip Code | 44473-9532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013525310 | Sandra St Louis Thompson | Nurse Practitioner | 3946 King Graves Rd, Vienna, OH 44473 | 2020-07-22 |
| 1992050413 | Emily Maki | Physical Therapist | 4543 Warren Sharon Rd, Vienna, OH 44473 | 2012-07-20 |
| 1184993271 | Pamela Irene Barnes | Licensed Practical Nurse | 705 Avalon Creek Blvd, Vienna, OH 44473 | 2011-12-20 |
| 1013028125 | Jose Lonappan Alappatt | Psychiatry & Neurology | 5315 Warren Sharon Rd, Vienna, OH 44473 | 2006-08-31 |
| 1336173046 | James Matthew Trapp | Dentist | 351 Youngstown Kingsville, Vienna, OH 44473 | 2006-07-10 |
| 1659304798 | Vienna Township Ttee | Ambulance | 833 Youngstown Kingsville Rd, Vienna, OH 44473 | 2006-07-09 |
| 1063764827 | Terri Ann Naughton | Counselor | 3976 King Graves Rd, Vienna, OH 44473-5903 | 2012-10-03 |
| 1750511911 | Virginia Lola Pettigrew-wheaton | Military Health Care Provider | 3976 King Graves Rd, 910th Mds (afrc), Vienna, OH 44473-6900 | 2009-07-22 |
| 1750654117 | Brittany Ann Burwell | Dentist | 3976 King Graves Rd, Vienna, OH 44473-6900 | 2012-02-15 |
| 1093960973 | Grace Swan-rickard | Licensed Practical Nurse | 4950 Smith Stewart Rd, Vienna, OH 44473-8604 | 2008-11-19 |
| Find all providers in zip 44473 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881206035 | Lutheran Social Services of Illinois | Psychologist | 45 Industrial Dr, Vienna, IL 62995-1674 | 2020-08-19 |
| 1982152831 | Gail Ann Kelsey | Psychologist | 131 Church St Nw, Vienna, VA 22180-4546 | 2016-09-20 |
| 1033568639 | Kyle Standiford | Psychologist | 360 Maple Ave W Ste F, Vienna, VA 22180-5614 | 2016-06-06 |
| 1740614783 | Ashley Hallheimer | Psychologist | 8381 Old Courthouse Rd Ste 330, Vienna, VA 22182-3818 | 2013-08-27 |
| 1457628448 | Christine M Howard | Psychologist | 8381 Old Courthouse Rd, Suite 330, Vienna, VA 22182-3818 | 2011-11-19 |
| 1790078152 | Normalbalance, LLC | Psychologist | 2235 Cedar Ln Ste 101, Vienna, VA 22182-5247 | 2011-05-18 |
| 1801043757 | Margarita Avedisian | Psychologist | 346 Maple Ave W, Vienna, VA 22180-5612 | 2008-08-22 |
| 1285894451 | Mary F. Schumann | Psychologist | 380 Maple Ave West, Suite 200, Vienna, VA 22180-5620 | 2008-06-11 |
| 1104003524 | John Russell Atkinson | Psychologist | 1007 38th St, Vienna, WV 26105-2741 | 2008-01-28 |
| 1083803456 | John P Allen | Psychologist | 2009 Carriage Ct, Vienna, VA 22181-2923 | 2007-10-22 |
| Find all providers in VIENNA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.