Individual provider · Type 1 NPI

Myisha L. Wallace

Marriage & Family Therapist · Riverview, FL

NPI number 1659062891 Active

Practice location

13190 Royal Pines Ave
Riverview, FL 33579-9321

Call (813) 520-0156 Map

Mailing address

7901 4th St N Ste 300
St. Petersburg, FL 33702-4399

Specialties and licenses

TaxonomyCodeLicense
Marriage & Family Therapist Primary 106H00000XMT5504 (FL)

Marriage & Family Therapist: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats ment…

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About NPI 1659062891

Myisha L. Wallace's National Provider Identifier is 1659062891, issued on May 18, 2023. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in Riverview, FL. The record was last updated on Jun 6, 2026.