Individual provider · Type 1 NPI
Tracey Wallace
Mental Health Counselor · Atlanta, GA
NPI number
1053748038
Active
Practice location
122 Wolf Tail Ct SW
Atlanta, GA 30349-6547
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
Another provider at this address
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About NPI 1053748038
Tracey Wallace's National Provider Identifier is 1053748038, issued on Oct 4, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Atlanta, GA. The record was last updated on Oct 4, 2013.