Individual provider · Type 1 NPI

Marisa Wallace, LPC

Professional Counselor · Mentor, OH

NPI number 1316417439 Active

Practice location

7232 Justin Way
Mentor, OH 44060-4881

Call (440) 578-8200 Map

Other practice locations

  • 23780 Farringdon Ave, Euclid, OH 44123-1537 · (216) 240-1111

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Professional Counselor Primary 101YP2500XC.190690 (OH)

Professional Counselor: Definition to come...

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About NPI 1316417439

Marisa Wallace, LPC's National Provider Identifier is 1316417439, issued on Dec 1, 2018. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Mentor, OH. The record was last updated on Feb 17, 2022.