Individual provider · Type 1 NPI
Deborah Faye Wallace, LCPC LICENSED CLINIC
Professional Counselor · Carlinville, IL
NPI number
1235999293
Active
Practice location
18772 Rt. 4
Carlinville, IL 62626
Mailing address
17232 Parkside Drive
Carlinville, IL 62626
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 180.003816 (IL) |
Professional Counselor: Definition to come...
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About NPI 1235999293
Deborah Faye Wallace, LCPC LICENSED CLINIC's National Provider Identifier is 1235999293, issued on Mar 19, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Carlinville, IL. The record was last updated on Mar 19, 2024.