PATRICIA WALLACE (NPI# 1861605719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861605719 |
| Entity Type | Individual |
| Full Name | PATRICIA WALLACE |
| Credential | PHD |
| Practice Address |
16000 W 9 Mile Rd Suite 615 Southfield MI 48075-4808 |
| Practice Telephone | 2485573820 |
| Mailing Telephone | 2485573820 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PW05231 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922434091 | Patricia J Wallace | Hearing Instrument Specialist | 1 Chesterfield Mall, Chesterfield, MO 63017-4807 | 2013-09-20 |
| 1043336704 | Patricia Irene Wallace | Counselor | 104 N 4th St, Hugo, OK 74743-4003 | 2007-03-22 |
| 1730683301 | Patricia Sue Wallace | Nurse Practitioner | 106 Market Place Cir, Georgetown, KY 40324-7400 | 2018-03-20 |
| 1548762958 | Patricia E. Wallace | Counselor | 3365 W Craig Rd Ste 25, North Las Vegas, NV 89032-5127 | 2018-03-01 |
| 1538606744 | Patricia Wallace | Occupational Therapist | 1755 Wittington Pl Ste 175, Dallas, TX 75234-1905 | 2017-01-25 |
| 1215398722 | Patricia Wallace | Marriage & Family Therapist | 901 N Pacific Coast Hwy, Suite 200a, Redondo Beach, CA 90277-2162 | 2016-03-10 |
| 1447553300 | Patricia A Wallace | Counselor | 450 Rosewood Ave, Suite215, Camarillo, CA 93010-5914 | 2010-12-15 |
| 1164750741 | Patricia Wallace | Occupational Therapist | 1818 W Worley St, Columbia, MO 65203-1038 | 2009-11-19 |
| 1174771281 | Patricia M Wallace | Acupuncturist | 217 1st St, Neptune Beach, FL 32266-6145 | 2008-09-03 |
| 1033393780 | Patricia Bonner Wallace | Counselor | 823 Evans St, Greenville, NC 27834-3267 | 2007-12-18 |
| Street Address |
16000 W 9 MILE RD SUITE 615 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942283718 | Q C N Home Care Systems, Inc. | Home Health | 16000 W 9 Mile Rd, Suite 220, Southfield, MI 48075-4808 | 2005-11-25 |
| 1467963066 | Pro Care Massage Clinic | Massage Therapist | 16000 W 9 Mile Rd, Southfield, MI 48075-4808 | 2017-10-23 |
| 1407376767 | Sandra Beard | Social Worker | 16000 W 9 Mile Rd, Southfield, MI 48075-4808 | 2017-06-27 |
| 1538692934 | Hope At Home Health Support Services LLC | Home Health | 16000 W 9 Mile Rd, Sut # 206, Southfield, MI 48075-4808 | 2017-04-04 |
| 1285171561 | Lela Stovall | Counselor | 16000 W 9 Mile Rd, Southfield, MI 48075-4808 | 2017-01-25 |
| 1447793245 | Melonie Barnes | Social Worker | 16000 W 9 Mile Rd, Sutie 510, Southfield, MI 48075-4808 | 2016-11-28 |
| 1811439284 | Abundance Home Care | Home Health | 16000 W 9 Mile Rd, Ste 117, Southfield, MI 48075-4808 | 2016-11-16 |
| 1831631597 | Ok 2 Playy | Preferred Provider Organization | 16000 W 9 Mile Rd, 112, Southfield, MI 48075-4808 | 2016-11-12 |
| 1609237619 | Lela Stovall, LLC | Day Training, Developmentally Disabled Services | 16000 W 9 Mile Rd, Suite 112, Southfield, MI 48075-4808 | 2016-03-18 |
| 1114387925 | Hmt Home Healthcare, LLC | Home Health | 16000 W 9 Mile Rd, Suite 409, Southfield, MI 48075-4808 | 2016-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831721794 | Sara Molloy | Psychologist | 16000 W 9 Mile Rd Ste 315, Southfield, MI 48075-4835 | 2020-02-10 |
| 1487138038 | Rose Camille Cook | Psychologist | 29500 Southfield Rd Ste 204, Southfield, MI 48076-2044 | 2018-09-19 |
| 1063951671 | Palina Drake | Psychologist | 21650 W 11 Mile Rd Ste 107, Southfield, MI 48076-3715 | 2017-02-15 |
| 1285016071 | The Help Couch, LLC | Psychologist | 29623 Northwestern Hwy, Southfield, MI 48034-1076 | 2015-06-29 |
| 1457745234 | Joseph Matthew Stabrava | Psychologist | 21221 Poinciana St, Southfield, MI 48033-5043 | 2015-03-19 |
| 1528461746 | Steven Mark Portnoy | Psychologist | 19875 Butternut Ln, Southfield, MI 48076-1795 | 2014-10-01 |
| 1790114098 | Matthew Buryta | Psychologist | 22190 W 9 Mile Rd, Southfield, MI 48033-6007 | 2013-11-06 |
| 1780988568 | Ruth Ann Hiner | Psychologist | 27136 Shagbark Dr, Southfield, MI 48076-3535 | 2011-01-07 |
| 1861637282 | Katherine A Zell | Psychologist | 22190 W. 9 Mile Rd., Southfield, MI 48334 | 2008-12-15 |
| 1245480961 | Jeffery Joseph Lusko | Psychologist | 24901 Northwestern Highway, Ste 500, Southfield, MI 48075 | 2008-09-30 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
Please comment or provide details below to improve the information on PATRICIA WALLACE.
| 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.