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1043892052
CARLA R WALLACE
FAYETTEVILLE, AR
NPI
1043892052
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AR LCSW)
Enumeration Date
2021-04-28
Last Update Date
2021-04-28
Business Address
CARLA R WALLACE LCSW
3465 N NORTHWOOD AVE
FAYETTEVILLE, AR 72704-5302
Phone number: 285-472-0882
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Mailing Address
CARLA R WALLACE LCSW
3465 N NORTHWOOD AVE
FAYETTEVILLE, AR 72704-5302
Phone number: 479-338-2559
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