Individual provider · Type 1 NPI

Mellani Maritza Wallace

Counselor · Brandon, MS

NPI number 1033799499 Active

Practice location

613 Marquette Rd
Brandon, MS 39042-3038

Call (601) 591-5553 Map

Mailing address

5749 Raymond Bolton Rd
Bolton, MS 39041-9253

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1033799499

Mellani Maritza Wallace's National Provider Identifier is 1033799499, issued on Apr 10, 2021. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Brandon, MS. The record was last updated on Apr 10, 2021.