Glen Knight Wallace, EDD is a
Counselor - Professional based in Okalhoma City, Oklahoma. Glen Knight Wallace is licensed to practice in Oklahoma (license number 535) and his current practice location is
7932 Nicholson, Okalhoma City, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(405) 728-1173.
NPI number for Glen Knight Wallace is 1548493091 and his current mailing address is 7932 Nicholson, Okalhoma City, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1548493091.
Healthcare Provider's Profile
Full Name | Glen Knight Wallace |
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Gender | Male |
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Speciality | Counselor - Professional |
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Location | 7932 Nicholson, Okalhoma City, Oklahoma |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1548493091
- Provider Enumeration Date: 09/01/2009
- Last Update Date: 09/01/2009
Medical Identifiers
Medical identifiers for Glen Knight Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1548493091 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | 535 (Oklahoma) | Primary |
106H00000X | Marriage & Family Therapist | 333 (Oklahoma) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glen Knight Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Glen Knight Wallace, EDD 7932 Nicholson, Okalhoma City, OK 73162 Ph: (405) 728-1173 | Glen Knight Wallace, EDD 7932 Nicholson, Okalhoma City, OK 73162 Ph: (405) 728-1173 |
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