Individual provider · Type 1 NPI

Connie Lee Wallace, LPCC-S, CTT

Mental Health Counselor · Dover, OH

NPI number 1386668200 Active

Practice location

547 1/2 S James St, Ste. A
Dover, OH 44622-2137

Call (330) 343-7400 Map

Fax (330) 343-7414

Mailing address

PO Box 534
New Philadelphia, OH 44663-0534

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XE0001636-SUPV (OH)
Professional Counselor 101YP2500XE0001636-SUPV (OH)

Mental Health Counselor: Definition to come...

3 other providers at this address

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About NPI 1386668200

Connie Lee Wallace, LPCC-S, CTT's National Provider Identifier is 1386668200, issued on Jul 26, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dover, OH. The record was last updated on Feb 16, 2016.