Provider Demographics
NPI:1568223519
Name:WALES, JOANNE ROSE MARIE
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:ROSE MARIE
Last Name:WALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3803
Mailing Address - Country:US
Mailing Address - Phone:716-334-7231
Mailing Address - Fax:
Practice Address - Street 1:4511 HARLEM RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3803
Practice Address - Country:US
Practice Address - Phone:716-334-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist