NPI 1003321720

Darre'Ll J Wallace

Practitioner Mental Health Counselor Shreveport, LA

Practice location

Address: 1711 Marshall St, Shreveport, LA 71101-4139
Phone: (318) 226-9944
Fax: (318) 226-9942

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

Other Counselor providers in Louisiana →

Registry record

NPI: 1003321720
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Dec 2017
Record last updated: 4 Dec 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.