Jolene C Wallace, COMS

Primary specialty

Orientation and Mobility Training Rehabilitation CounselorTaxonomy code 225CX0006X

Practice address

110 Apple House LN
Missoula, MT 59802-3324

Phone

(406) 360-9480

Fax

(406) 549-3581

NPI assigned

Mar 11, 2016

Last updated

Mar 11, 2016By the provider in NPPES

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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1861853269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 APPLE HOUSE LN",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023324",
            "telephone_number": "406-360-9480",
            "fax_number": "406-549-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 APPLE HOUSE LN",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598023324",
            "telephone_number": "406-360-9480",
            "fax_number": "406-549-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JOLENE",
        "middle_name": "C",
        "credential": "COMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225CX0006X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Orientation and Mobility Training Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Rehabilitation Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.