| NPI | 1003382938 |
|---|---|
| Professional Name | EDWINA WALLACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401222814) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401011732) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2026-09-11 |