Mr. DARRELL DEWAYNE WALLACE LGPC ⚕️ Maryland 1265086367

NPI	1265086367
Entity Type	Individual
Gender	Male
Sole Proprietor ?	Yes
Primary Taxonomy	101YM0800X Counselor, Mental Health (Licence: MD LGP9687)
Enumeration Date	2019-07-26
Last Update Date	2019-07-26

Mr. DARRELL DEWAYNE WALLACE LGPC

107 E 25TH ST

BALTIMORE, MD 21218-5213

Phone number: 410-558-0019

Mr. DARRELL DEWAYNE WALLACE LGPC

553 MARC RD # A

MILLERSVILLE, MD 21108-1525

Phone number: 443-694-7554