Jesseca Marie Wallace, is a
Case Manager/care Coordinator based in Streetsboro, Ohio. Jesseca Marie Wallace is licensed to practice in * (Not Available) (license number ) and her current practice location is
8720 Mavis Trl, Streetsboro, Ohio. She can be reached at her office (for appointments etc.) via phone at
(440) 384-8934.
NPI number for Jesseca Marie Wallace is 1245871177 and her current mailing address is 8720 Mavis Trl, Streetsboro, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245871177.
Healthcare Provider's Profile
| Full Name | Jesseca Marie Wallace |
|---|
| Gender | Female |
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| Speciality | Case Manager/care Coordinator |
|---|
| Location | 8720 Mavis Trl, Streetsboro, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245871177
- Provider Enumeration Date: 10/02/2019
- Last Update Date: 09/24/2020
Medical Identifiers
Medical identifiers for Jesseca Marie Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245871177 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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. Jesseca Marie 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 |
|---|
Jesseca Marie Wallace,
8720 Mavis Trl,
Streetsboro, OH 44241-4219
Ph: () - | Jesseca Marie Wallace,
8720 Mavis Trl,
Streetsboro, OH 44241
Ph: (440) 384-8934 |
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