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1174108682
LANDON WALLACE
LEXINGTON, SC
NPI
1174108682
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: SC 8287)
Enumeration Date
2021-03-16
Last Update Date
2023-09-20
Business Address
LANDON WALLACE
305 PALMETTO PARK BLVD
LEXINGTON, SC 29072-7872
Phone number: 803-996-1500
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Mailing Address
LANDON WALLACE
108 PALMETTO PARK BLVD
LEXINGTON, SC 29072-7968
Phone number: 803-996-1500
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