Individual provider · Type 1 NPI
Elaine Marie Wallace, LCPC
Professional Counselor · Glen Burnie, MD
NPI number
1962084574
Active
Practice location
204 Somerset Bay Dr Apt 201
Glen Burnie, MD 21061-6476
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LC13561 (MD) |
Professional Counselor: Definition to come...
Another provider at this address
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About NPI 1962084574
Elaine Marie Wallace, LCPC's National Provider Identifier is 1962084574, issued on Apr 22, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glen Burnie, MD. The record was last updated on Aug 29, 2023.