MARIE L. WALLACE (NPI# 1548525934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548525934 |
| Entity Type | Individual |
| Full Name | MARIE L. WALLACE |
| Credential | CPC PERMIT #IP150410 |
| Practice Address |
3606 North Roncho Dr Suite 102 Las Vegas NV 89130 |
| Mailing Address |
10327 Birch Bluff Ln Las Vegas NV 89145 |
| Practice Telephone | 5044005768 |
| Mailing Telephone | 7023041551 |
| Mailing Fax Number | 7023041551 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2015-05-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710269519 | Marie Wallace | Speech-Language Pathologist | 077 Worthington Point Road, Berlin, CT 06037 | 2011-09-16 |
| 1033591045 | Marie Renee Wallace | Counselor | 7204 Skyway, Paradise, CA 95969-3280 | 2015-06-25 |
| Street Address |
3606 NORTH RONCHO DR SUITE 102 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374031 | Mindworks Behavioral Health & Medical Center | Clinic/Center | 7495 W. Azure Dr., Ste. 240, Las Vegas, NV 89130 | 2019-12-26 |
| 1669033833 | Doran Gaston | Behavioral Analyst | 3560 N Rancho Dr., Suite 109, Las Vegas, NV 89130 | 2019-06-27 |
| 1700447547 | Lakeisha Lloved | Behavioral Analyst | 3650 N Ranch Dr., Suite 109, Las Vegas, NV 89130 | 2019-06-24 |
| 1952962797 | Dana Lloved | Behavioral Analyst | 5650 N. Rancho Dr., 109, Las Vegas, NV 89130 | 2019-06-24 |
| 1316501596 | Positively Therapy | Counselor | 5071 N Rainbow Blvd #170, Las Vegas, NV 89130 | 2019-04-23 |
| 1427518356 | Rebecca Aragon | Behavioral Analyst | 5803 West Craig Road, Las Vegas, NV 89130 | 2019-03-25 |
| 1568929198 | Clear Choice Therapeutic Center, LLC | Community/Behavioral Health | 4079 North Rancho Drive, Suite 160, Las Vegas, NV 89130 | 2019-03-01 |
| 1699239095 | Jennifer Lee Kearns | Rehabilitation Practitioner | 3680 N Racho Drive, Las Vegas, NV 89130 | 2019-01-30 |
| 1730651852 | Sunrise Adult Day Care | Clinic/Center | 3930 Leon Ave #130, Las Vegas, NV 89130 | 2018-12-31 |
| 1376015685 | Sunrise Adult Day Care | Clinic/Center | 3930 Leon Ave Suite # 130, Las Vegas, NV 89130 | 2018-12-27 |
| Find all providers in zip 89130 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656438 | Brittney Mary Sobwick | Rehabilitation Practitioner | 8360 W Sahara Ave Ste 230, Las Vegas, NV 89117-8945 | 2020-10-12 |
| 1184234544 | Karina Mandello | Rehabilitation Practitioner | 8250 N Grand Canyon Dr Unit 2121, Las Vegas, NV 89166-3734 | 2020-07-31 |
| 1730797408 | Jeffrey Michael Stovall | Rehabilitation Practitioner | 7037 Fort Union Ct, Las Vegas, NV 89179-1206 | 2020-07-20 |
| 1194333716 | Francisco Javier Robles | Rehabilitation Practitioner | 2810 W Charleston Blvd Ste H77, Las Vegas, NV 89102-1921 | 2020-07-20 |
| 1073121836 | Genna Villanueva | Rehabilitation Practitioner | 6612 Sand Bench Ave, Las Vegas, NV 89130-4801 | 2020-07-17 |
| 1861000895 | Carolyn Mccrae | Rehabilitation Practitioner | 11245 Vintners Ln, Las Vegas, NV 89138-1503 | 2020-07-15 |
| 1871119404 | Andrew Hunt | Rehabilitation Practitioner | 9557 Green Spruce St, Las Vegas, NV 89123-3573 | 2020-06-19 |
| 1861018566 | Tshawnalyn Alize Nicole Puryear | Rehabilitation Practitioner | 6300 W Tropicana Ave Trlr 159, Las Vegas, NV 89103-4422 | 2020-06-19 |
| 1962024661 | Ernestina Huerta | Rehabilitation Practitioner | 6933 Cobblestone Ave, Las Vegas, NV 89145-5349 | 2020-05-15 |
| 1538789102 | Thomas Putnam | Rehabilitation Practitioner | 7824 Nesting Pine Pl, Las Vegas, NV 89143-4468 | 2020-04-23 |
| Find all providers in LAS VEGAS | ||||
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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.