DARRE'LL J WALLACE

SHREVEPORT, LA
NPI1003321720
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2017-12-04
Last Update Date2017-12-04
Business Address
DARRE'LL J WALLACE
1711 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number: 318-226-9944
Mailing Address
DARRE'LL J WALLACE
1711 MARSHALL ST
SHREVEPORT, LA 71101-4139
Phone number: 318-226-9944
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