Individual provider · Type 1 NPI

Darre'll J. Wallace

Mental Health Counselor · Shreveport, LA

NPI number 1003321720 Active

Practice location

1711 Marshall St
Shreveport, LA 71101-4139

Call (318) 226-9944 Map

Fax (318) 226-9942

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1003321720

Darre'll J. Wallace's National Provider Identifier is 1003321720, issued on Dec 4, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Shreveport, LA. The record was last updated on Dec 4, 2017.