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1154820868
NICOLE JANEEN WALLACE
RALEIGH, NC
NPI
1154820868
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: NC A13547)
Enumeration Date
2018-02-08
Last Update Date
2021-01-05
Business Address
NICOLE JANEEN WALLACE LCMHC
3041 BERKS WAY STE 102C
RALEIGH, NC 27614-6777
Phone number: 919-925-2274
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Mailing Address
NICOLE JANEEN WALLACE LCMHC
PO BOX 627
WAKE FOREST, NC 27588-0627
Phone number: 919-306-2579
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