Individual provider · Type 1 NPI

Mara Wallace, LPC

Professional Counselor · Elizabeth, PA

NPI number 1508544883 Active

Practice location

95 Enterprise St Ste 104
Elizabeth, PA 15037-2070

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XPC015793 (PA)

Professional Counselor: Definition to come...

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About NPI 1508544883

Mara Wallace, LPC's National Provider Identifier is 1508544883, issued on Jul 7, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Elizabeth, PA. The record was last updated on Jul 7, 2023.