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1265888374
EBONY LASHAWN WALLACE
BATON ROUGE, LA
NPI
1265888374
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2016-05-06
Last Update Date
2019-12-02
Business Address
Ms. EBONY LASHAWN WALLACE
8326 KELWOOD AVE
BATON ROUGE, LA 70806-4803
Phone number: 225-929-9738
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Mailing Address
Ms. EBONY LASHAWN WALLACE
1000 CHINABERRY DR STE 900
BOSSIER CITY, LA 71111-2455
Phone number: 318-459-6795
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