Individual provider · Type 1 NPI

Tracy Wallace, LGPC

Professional Counselor · Lutherville Timonium, MD

NPI number 1366229874 Active

Practice location

9475 Deereco Rd Ste 410
Lutherville Timonium, MD 21093-2124

Call (410) 560-6135 Map

Fax (410) 560-6136

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XLGP14259 (MD)

Professional Counselor: Definition to come...

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About NPI 1366229874

Tracy Wallace, LGPC's National Provider Identifier is 1366229874, issued on Sep 11, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Lutherville Timonium, MD. The record was last updated on Sep 11, 2023.