MARY WALLACE (NPI# 1528585031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528585031 |
| Entity Type | Individual |
| Full Name | MARY WALLACE |
| Practice Address |
1605 E Ash St Canton IL 61520-1510 |
| Practice Telephone | (309) 647-6951 |
| Mailing Telephone | 3096476951 |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2017-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801136809 | Mary Etheridge Wallace | Counselor | 303 E. Main Street Suite 9, Elizabeth City, NC 27909 | 2013-02-27 |
| 1851541163 | Mary Caroline Wallace | Speech-Language Pathologist | 5 5th St Se, Washington, DC 20003-1119 | 2008-09-23 |
| 1245446723 | Mary Frances Wallace | Massage Therapist | 3301 River Ave, Huntington, WV 25705-2807 | 2007-05-14 |
| 1134253396 | Mary Beth Wallace | Speech-Language Pathologist | 2461 Highway 1, Harrisburg, AR 72432-9479 | 2007-03-16 |
| 1619045648 | Mary D Wallace | Social Worker | 105 Broadview Dr, Syracuse, NY 13215-1505 | 2006-11-30 |
| 1013451608 | Mary Elise Wallace | Dietitian, Registered | 3600 Gaston Ave, Suite 656, Dallas, TX 75246-1800 | 2016-12-15 |
| 1982156766 | Mary Terese Wallace | Dietitian, Registered | 700 Broadway, Seattle, WA 98122-4302 | 2016-10-27 |
| 1194173443 | Mary Wallace | Case Manager/Care Coordinator | 627 S Elliott Ave, Wenatchee, WA 98801-3195 | 2016-05-27 |
| 1255760898 | Mary Wallace | Counselor | 1818 Se Division St, Portland, OR 97202-1159 | 2013-11-04 |
| 1811127947 | Mary Virginia Wallace | Social Worker | 1401 N Central Expy, Suite 375, Richardson, TX 75080-4669 | 2009-07-23 |
| Street Address |
1605 E ASH ST |
| City | CANTON |
| State | IL |
| Zip Code | 61520-1510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014977 | Makenzie Mayall | Speech-Language Pathologist | 1605 E Ash St, Canton, IL 61520-1510 | 2020-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| Find all providers in zip 61520 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538563366 | Lauren Miller | Psychologist | 1503 Woodland Ave Nw, Canton, OH 44703 | 2014-10-22 |
| 1396147500 | Samantha Marie Barsa | Psychologist | 412 Clarendon Ave Nw, Canton, OH 44708-4506 | 2014-09-18 |
| 1154745313 | Jennifer Nishaun Lewis | Psychologist | 1312 5th St Sw, Canton, OH 44707-4657 | 2014-02-08 |
| 1346214830 | Canton Area School District | Psychologist | 141 E Union St, Canton, PA 17724-1205 | 2006-02-14 |
| 1538614359 | Andrea Jo Austin | Psychologist | 1801 Schneider St Ne, Canton, OH 44721-3349 | 2016-08-22 |
| 1245699800 | Kelly Ostrout | Psychologist | 1801 Schneider St Ne, Canton, OH 44721-3349 | 2016-02-11 |
| 1194183327 | Amy Saylor | Psychologist | 1801 Schneider St Ne, Canton, OH 44721-3349 | 2016-02-02 |
| 1407227572 | Linda Mcconnell | Psychologist | 305 Mckinley Ave Nw, Canton, OH 44702-1717 | 2015-10-14 |
| 1134513815 | Rochelle Anne Haas | Psychologist | 2100 38th St Nw, Canton, OH 44709-2312 | 2015-03-20 |
| 1134511447 | Maria Gaglio | Psychologist | 2100 38th St Nw, Canton, OH 44709-2312 | 2015-02-24 |
| Find all providers in CANTON | ||||
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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.