Kenneth Ralph Wallace Ii, PSYD - Psychologist in Vienna, OH

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Kenneth Ralph Wallace Ii, PSYD is a Psychologist - Clinical based in Vienna, Ohio. Kenneth Ralph Wallace Ii is licensed to practice in Ohio (license number 4838) and his current practice location is 3400 Warren-sharon Road, Vienna, Ohio. He can be reached at his office (for appointments etc.) via phone at (330) 720-5768.

NPI number for Kenneth Ralph Wallace Ii is 1417135815 and his current mailing address is 3400 Warren-sharon Road, Vienna, Ohio. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417135815.

Contact Information

Kenneth Ralph Wallace Ii, PSYD
3400 Warren-sharon Road,
Vienna, OH 44473-9532
(330) 720-5768
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKenneth Ralph Wallace Ii
GenderMale
SpecialityPsychologist - Clinical
Location3400 Warren-sharon Road, Vienna, Ohio
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1417135815
  • Provider Enumeration Date: 02/07/2008
  • Last Update Date: 02/07/2008

Medical Identifiers

Medical identifiers for Kenneth Ralph Wallace Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417135815NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical PS015513 (Pennsylvania)Secondary
103TC0700XPsychologist - Clinical 4838 (Ohio)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. Kenneth Ralph Wallace Ii 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 AddressPractice Location Address
Kenneth Ralph Wallace Ii, PSYD
3400 Warren-sharon Road,
Vienna, OH 44473-9532

Ph: (330) 720-5768		Kenneth Ralph Wallace Ii, PSYD
3400 Warren-sharon Road,
Vienna, OH 44473-9532

Ph: (330) 720-5768

Reviews and Comments


Psychologist in Vienna, OH


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