Individual provider · Type 1 NPI
Shanthalitta Seals Wallace, LMHC
Mental Health Counselor · Jacksonville, FL
NPI number
1659848539
Active
Practice location
9617 Watershed Dr E
Jacksonville, FL 32220-0906
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | MH15387 (FL) |
Mental Health Counselor: Definition to come...
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About NPI 1659848539
Shanthalitta Seals Wallace, LMHC's National Provider Identifier is 1659848539, issued on Oct 29, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jacksonville, FL. The record was last updated on Oct 29, 2018.