Individual provider · Type 1 NPI

Jerryd Wallace, LPC

Professional Counselor · Van Alstyne, TX

NPI number 1821573387 Active

Practice location

162 N. Dallas Ave
Van Alstyne, TX 75495-7549

Call (469) 667-3515 Map

Mailing address

PO Box 2020
Van Alstyne, TX 75495-2020

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X77418 (TX)

Professional Counselor: Definition to come...

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About NPI 1821573387

Jerryd Wallace, LPC's National Provider Identifier is 1821573387, issued on Oct 1, 2018. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Van Alstyne, TX. The record was last updated on Oct 1, 2018.