Individual provider · Type 1 NPI

Donna Wallace

Mental Health Counselor · Fort Pierce, FL

NPI number 1639558471 Active

Practice location

2814 S US Highway 1, Suite D-4
Fort Pierce, FL 34982-8120

Call (772) 501-3057 Map

Mailing address

567 NW Lake Whitney Pl Ste 101
Port St. Lucie, FL 34986-1629

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1639558471

Donna Wallace's National Provider Identifier is 1639558471, issued on May 26, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Pierce, FL. The record was last updated on Mar 19, 2019.