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1104637461
DESIREE WALLACE
BALTIMORE, MD
NPI
1104637461
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD ADT2383)
Enumeration Date
2025-01-16
Last Update Date
2025-01-16
Business Address
DESIREE WALLACE
3310 EASTERN AVE
BALTIMORE, MD 21224-4108
Phone number: 443-708-5056
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Mailing Address
DESIREE WALLACE
501 SAINT PAUL ST APT 1004
BALTIMORE, MD 21202-2280
Phone number:
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