Individual provider · Type 1 NPI

Juanita Wallace

Mental Health Counselor · Florissant, MO

NPI number 1326164278 Active

Practice location

570 Shackelford Rd
Florissant, MO 63031-5457

Call (314) 583-0549 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X2002006418 (MO)

Mental Health Counselor: Definition to come...

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About NPI 1326164278

Juanita Wallace's National Provider Identifier is 1326164278, issued on Mar 22, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Florissant, MO. The record was last updated on Jul 9, 2007.