Marzette Wallace

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

1330 N Classen Blvd
Suite 306
Oklahoma City, OK 73106-6835

Phone

(405) 694-4053

Fax

(405) 225-7326

NPI assigned

Nov 5, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1396118808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6103 N MERIDIAN AVE",
            "address_2": "APT 114",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731121255",
            "telephone_number": "405-635-7512",
            "fax_number": "405-225-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N CLASSEN BLVD",
            "address_2": "SUITE 306",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731066835",
            "telephone_number": "405-694-4053",
            "fax_number": "405-225-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MARZETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Schroeder Wallace, PH.D
• Keshawn Wallace, LPC-ASSOCIATE
• Kirsten Ann Wallace, PT
• Leslie Dawn Wallace
• Mark Wallace
• Melony Wallace
• Misty Wallace
• Nzuri Wallace, LADC/MH CANDIDATE
• Rebecca Wallace
• Rebecca M Wallace, PSY.D.

• Case Management Agency in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Case Management Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.