DARRELL DEWAYNE WALLACE

BALTIMORE, MD
NPI1265086367
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: MD  LGP9687)
Enumeration Date2019-07-26
Last Update Date2019-07-26
Business Address
MR. DARRELL DEWAYNE WALLACE LGPC
107 E 25TH ST
BALTIMORE, MD 21218-5213
Phone number: 410-558-0019
Mailing Address
MR. DARRELL DEWAYNE WALLACE LGPC
553 MARC RD # A
MILLERSVILLE, MD 21108-1525
Phone number: 443-694-7554
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