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1255116893
MARY WALLACE
HELOTES, TX
NPI
1255116893
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: TX 91155)
Enumeration Date
2023-08-30
Last Update Date
2023-08-30
Business Address
MARY WALLACE M.S, LPC-A
12274 BANDERA RD STE 101
HELOTES, TX 78023-4386
Phone number: 210-396-7609
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Mailing Address
MARY WALLACE M.S, LPC-A
8603 N LOOP 1604 W APT 5204
SAN ANTONIO, TX 78249-2646
Phone number: 708-979-5163
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