Provider Demographics
NPI:1487960985
Name:WALLACE, RASHIKA NELSON (MSW)
Entity type:Individual
Prefix:
First Name:RASHIKA
Middle Name:NELSON
Last Name:WALLACE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4914 FITZHUGH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3534
Mailing Address - Country:US
Mailing Address - Phone:804-213-2662
Mailing Address - Fax:888-855-4860
Practice Address - Street 1:4914 FITZHUGH AVE STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3534
Practice Address - Country:US
Practice Address - Phone:804-213-2662
Practice Address - Fax:888-855-4860
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical