Individual provider · Type 1 NPI

Darrell Dewayne Wallace Jr., LGPC

Mental Health Counselor · Baltimore, MD

NPI number 1265086367 Active

Practice location

107 E 25th St
Baltimore, MD 21218-5213

Call (410) 558-0019 Map

Mailing address

553 Marc Rd # A
Millersville, MD 21108-1525

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLGP9687 (MD)

Mental Health Counselor: Definition to come...

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About NPI 1265086367

Darrell Dewayne Wallace Jr., LGPC's National Provider Identifier is 1265086367, issued on Jul 26, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Baltimore, MD. The record was last updated on Jul 26, 2019.