Individual provider · Type 1 NPI
Loretta Wallace
Addiction (Substance Use Disorder) Counselor · New York, NY
NPI number
1932043957
Active
Practice location
60 E 112th St Apt 402
New York, NY 10029-0314
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 41880 (NY) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1932043957
Loretta Wallace's National Provider Identifier is 1932043957, issued on Apr 18, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in New York, NY. The record was last updated on Apr 18, 2026.