Dedra Wallace
Counselor - Professional
About Dedra Wallace
Dedra Wallace is a female healthcare professional specializing in Counselor - Professional with a focus on Professional, registered under National Provider Identifier (NPI) number 1063810877. Dedra Wallace received her medical education at OTHER, graduating in 2014.
Their primary practice is located at 1302 CHINOOK LN, Pueblo, Colorado 81001. Patients can reach the office at (719) 545-2746. Dedra Wallace is enrolled in Medicare and accepts Medicare patients, is authorized to order and refer Medicare services.
Dedra Wallace has been NPI-registered since 2014.
Key Metrics
Practice Locations
1
Doctor Details
Identity & Credentials
- NPI Number
- 1063810877
- Entity Type
- Individual
- First Name
- Dedra
- Last Name
- Wallace
- Gender
- Female
- Medical School
- OTHER
- Graduation Year
- 2014
- Sole Proprietor
- No
- Status
- active
Primary Practice Location
- Address
- 1302 CHINOOK LN
- City
- Pueblo
- State
- Colorado
- ZIP
- 81001-1851
- Country
- United States
- Phone
- (719) 545-2746
- Fax
- (719) 545-4100
Specialty & Taxonomy
- Primary Specialty
- Counselor - Professional
- Classification
- Counselor
- Specialization
- Professional
- Taxonomy Code
- 101YP2500X
NPI Registration
- Enumeration Date
- Last Updated
- Certification Date
Mailing Address
- Address
- 41 MONTEBELLO ROAD
- City
- PUEBLO
- State
- CO
- ZIP
- 810041128
Medicare Enrollment
- Medicare Enrolled
- Yes
- Can Order/Refer
- Yes
- Telehealth
- No
- Excluded
- No
Frequently Asked Questions
What is Dedra Wallace's NPI number?
What does Dedra Wallace specialize in?
Where is Dedra Wallace located?
Does Dedra Wallace accept Medicare?
Does Dedra Wallace offer telehealth or virtual visits?
What is an NPI Number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). Required under HIPAA, every healthcare provider who transmits health information electronically must have an NPI. The NPI for Dedra Wallace is 1063810877.