Individual provider · Type 1 NPI
Kerrie Wallace
Professional Counselor · Willis, TX
NPI number
1083161558
Active
Practice location
12839 Virgo Dr
Willis, TX 77318-5251
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 7693 (TX) |
| Professional Counselor Primary | 101YP2500X | 14980 (TX) |
Professional Counselor: Definition to come...
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About NPI 1083161558
Kerrie Wallace's National Provider Identifier is 1083161558, issued on Sep 1, 2016. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Willis, TX. The record was last updated on Sep 1, 2016.